Healthcare Provider Details

I. General information

NPI: 1225952443
Provider Name (Legal Business Name): ANDREA ROMO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8009 BRUCEVILLE RD STE 100
SACRAMENTO CA
95823-2332
US

IV. Provider business mailing address

8009 BRUCEVILLE RD STE 100
SACRAMENTO CA
95823-2332
US

V. Phone/Fax

Practice location:
  • Phone: 916-288-0326
  • Fax:
Mailing address:
  • Phone: 916-288-0326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95408740
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: