Healthcare Provider Details

I. General information

NPI: 1255347159
Provider Name (Legal Business Name): JEFF EMIL GEBERS RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 STOCKTON BLVD
SACRAMENTO CA
95816-6653
US

IV. Provider business mailing address

PO BOX 1864
ELK GROVE CA
95759-1864
US

V. Phone/Fax

Practice location:
  • Phone: 916-492-7240
  • Fax: 916-736-1072
Mailing address:
  • Phone: 916-492-7240
  • Fax: 916-736-1072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number517295
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: