Healthcare Provider Details

I. General information

NPI: 1639988389
Provider Name (Legal Business Name): ELIZABETH ADRIANA GARCIA HHA AND NURSING AGEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 SEBASTIAN WAY
SACRAMENTO CA
95864-2737
US

IV. Provider business mailing address

1412 SEBASTIAN WAY
SACRAMENTO CA
95864-2737
US

V. Phone/Fax

Practice location:
  • Phone: 916-969-9351
  • Fax:
Mailing address:
  • Phone: 916-969-9351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberGNB3202300199
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: