Healthcare Provider Details

I. General information

NPI: 1407525744
Provider Name (Legal Business Name): NAOKA S IWAYA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5445 LAUREL HILLS DR
SACRAMENTO CA
95841-3105
US

IV. Provider business mailing address

5445 LAUREL HILLS DR
SACRAMENTO CA
95841-3105
US

V. Phone/Fax

Practice location:
  • Phone: 916-609-5100
  • Fax:
Mailing address:
  • Phone: 916-609-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: