Healthcare Provider Details

I. General information

NPI: 1144153693
Provider Name (Legal Business Name): RYLEE PAIGE FOCHTMAN BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 HURLEY WAY STE 290
SACRAMENTO CA
95825-3221
US

IV. Provider business mailing address

2323 I ST APT 11
SACRAMENTO CA
95816-4213
US

V. Phone/Fax

Practice location:
  • Phone: 916-272-1570
  • Fax:
Mailing address:
  • Phone: 951-317-1415
  • 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: