Healthcare Provider Details

I. General information

NPI: 1740836667
Provider Name (Legal Business Name): MARIA CARBONELL SALVAT MSN, RN, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 2131
SACRAMENTO CA
95812-2131
US

IV. Provider business mailing address

2570 48TH ST
SACRAMENTO CA
95817-1541
US

V. Phone/Fax

Practice location:
  • Phone: 916-886-0687
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number95157309
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95157309
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: