Healthcare Provider Details

I. General information

NPI: 1871419994
Provider Name (Legal Business Name): DORU JUGANARU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6032 CRATER LAKE DR
ROSEVILLE CA
95678-1970
US

IV. Provider business mailing address

6032 CRATER LAKE DR
ROSEVILLE CA
95678-1970
US

V. Phone/Fax

Practice location:
  • Phone: 916-912-2035
  • Fax:
Mailing address:
  • Phone: 916-912-2035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number315002794
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: