Healthcare Provider Details

I. General information

NPI: 1285754762
Provider Name (Legal Business Name): BARBARA JACHNIEWICZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 06/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 STOCKTON BLVD CYPRESS BUILDING , SUIT E
SACRAMENTO CA
95817-1418
US

IV. Provider business mailing address

2221 STOCKTON BLVD CYPRESS BUILDING , SUIT E
SACRAMENTO CA
95817-1418
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2680
  • Fax: 916-743-7613
Mailing address:
  • Phone: 916-734-2680
  • Fax: 916-743-7613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number536209
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF335038
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20776
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: