Healthcare Provider Details

I. General information

NPI: 1851072144
Provider Name (Legal Business Name): JAZMINE LYNN SAPENTER-COULTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2023
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 WATT AVE STE 110
SACRAMENTO CA
95821-2622
US

IV. Provider business mailing address

3800 WATT AVE STE 110
SACRAMENTO CA
95821-2622
US

V. Phone/Fax

Practice location:
  • Phone: 916-344-0249
  • Fax:
Mailing address:
  • Phone: 916-344-0249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-KIZQWO
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: