Healthcare Provider Details

I. General information

NPI: 1609495845
Provider Name (Legal Business Name): PAULINA VEGA ENRIQUEZ M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 V ST STE G500
SACRAMENTO CA
95817-1460
US

IV. Provider business mailing address

4150 V ST STE G500
SACRAMENTO CA
95817-1460
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-3815
  • Fax:
Mailing address:
  • Phone: 916-734-3817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD61579557
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA210641
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: