Healthcare Provider Details

I. General information

NPI: 1356449680
Provider Name (Legal Business Name): ZARAH ANGELIE LAROA CROWLEY LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 STOCKTON BLVD
SACRAMENTO CA
95817-1337
US

IV. Provider business mailing address

6191 ORSI CIR
CARMICHAEL CA
95608-0217
US

V. Phone/Fax

Practice location:
  • Phone: 916-875-1089
  • Fax: 916-875-1004
Mailing address:
  • Phone: 916-536-0272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN 190346
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: