Healthcare Provider Details

I. General information

NPI: 1073701108
Provider Name (Legal Business Name): JEANNE BETH INMAN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CIRBY HILLS DR
ROSEVILLE CA
95678-4360
US

IV. Provider business mailing address

8248 CROSSOAK WAY
ORANGEVALE CA
95662-2947
US

V. Phone/Fax

Practice location:
  • Phone: 916-787-8800
  • Fax: 916-787-8857
Mailing address:
  • Phone: 916-722-6434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number384357
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: