Healthcare Provider Details

I. General information

NPI: 1316698616
Provider Name (Legal Business Name): HEATHER PANNETTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3840 WATT AVE BLDG B
SACRAMENTO CA
95821-2640
US

IV. Provider business mailing address

3840 WATT AVE BLDG B
SACRAMENTO CA
95821-2640
US

V. Phone/Fax

Practice location:
  • Phone: 916-588-9080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20492
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: