Healthcare Provider Details

I. General information

NPI: 1912632985
Provider Name (Legal Business Name): KAREN ANNE TRIEST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2022
Last Update Date: 07/22/2022
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 MORSE AVE
SACRAMENTO CA
95825-2115
US

IV. Provider business mailing address

2025 MORSE AVE
SACRAMENTO CA
95825-2115
US

V. Phone/Fax

Practice location:
  • Phone: 916-973-7924
  • Fax:
Mailing address:
  • Phone: 916-973-7924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberTCH8085
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: