Healthcare Provider Details

I. General information

NPI: 1942258207
Provider Name (Legal Business Name): RODOLFO ENCINA ECHIPARE SR. RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 N C ST
SACRAMENTO CA
95814-0608
US

IV. Provider business mailing address

1321 N C ST
SACRAMENTO CA
95814-0608
US

V. Phone/Fax

Practice location:
  • Phone: 916-447-1389
  • Fax:
Mailing address:
  • Phone: 916-447-1389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number658509
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: