Healthcare Provider Details

I. General information

NPI: 1831515584
Provider Name (Legal Business Name): JAMES JOSEPH LAPERLE RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2014
Last Update Date: 03/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 STOCKTON BLVD
SACRAMENTO CA
95817-1337
US

IV. Provider business mailing address

2150 STOCKTON BLVD
SACRAMENTO CA
95817-1337
US

V. Phone/Fax

Practice location:
  • Phone: 916-875-6955
  • Fax: 916-875-1001
Mailing address:
  • Phone: 916-875-6955
  • Fax: 916-875-1001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number451155
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: