Healthcare Provider Details

I. General information

NPI: 1821192261
Provider Name (Legal Business Name): LOIS ANN PHILLIPS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N MARKET BLVD SUITE 350
SACRAMENTO CA
95834-1200
US

IV. Provider business mailing address

8852 HIDDENSPRING WAY
ELK GROVE CA
95758-6153
US

V. Phone/Fax

Practice location:
  • Phone: 916-922-2771
  • Fax: 916-922-8608
Mailing address:
  • Phone: 916-684-5042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number143924
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: