Healthcare Provider Details

I. General information

NPI: 1073427142
Provider Name (Legal Business Name): MCKENNA ROSE HATFIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 SUNSET BLVD
ROCKLIN CA
95677-3095
US

IV. Provider business mailing address

2520 INVERNESS DR
LINCOLN CA
95648-9576
US

V. Phone/Fax

Practice location:
  • Phone: 916-773-0211
  • Fax:
Mailing address:
  • Phone: 404-558-0294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: