Healthcare Provider Details

I. General information

NPI: 1154939163
Provider Name (Legal Business Name): GABRIELA CARRICO DNP, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2020
Last Update Date: 01/22/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 HOSPITAL DR STE J-1
SACRAMENTO CA
95823-5406
US

IV. Provider business mailing address

4520 MCMURTRY LN
VACAVILLE CA
95688-9104
US

V. Phone/Fax

Practice location:
  • Phone: 916-718-0002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number95140297
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95022844
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: