Healthcare Provider Details

I. General information

NPI: 1427687326
Provider Name (Legal Business Name): NANCY HILIANA GUTIERREZ-FERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2020
Last Update Date: 04/03/2020
Certification Date: 04/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2731 MORSE AVE
SACRAMENTO CA
95821-6142
US

IV. Provider business mailing address

2731 MORSE AVE
SACRAMENTO CA
95821-6142
US

V. Phone/Fax

Practice location:
  • Phone: 831-406-2706
  • Fax:
Mailing address:
  • Phone: 831-406-2706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number709474
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: