Healthcare Provider Details

I. General information

NPI: 1710564299
Provider Name (Legal Business Name): GARRETT CHRISTOPHER SOVELLE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: GARRETT CHRISTOPHER SIMKINS MD

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 SIERRA GARDENS DR
ROSEVILLE CA
95661-2912
US

IV. Provider business mailing address

1840 SIERRA GARDENS DR
ROSEVILLE CA
95661-2912
US

V. Phone/Fax

Practice location:
  • Phone: 916-784-4190
  • Fax: 916-787-6450
Mailing address:
  • Phone: 916-784-4190
  • Fax: 916-787-6450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA201670
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: