Healthcare Provider Details

I. General information

NPI: 1952869851
Provider Name (Legal Business Name): KATHLEEN A ROONEY MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2019
Last Update Date: 03/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2277 FAIR OAKS BLVD STE 355
SACRAMENTO CA
95825-5595
US

IV. Provider business mailing address

2277 FAIR OAKS BLVD STE 355
SACRAMENTO CA
95825-5595
US

V. Phone/Fax

Practice location:
  • Phone: 916-927-3178
  • Fax: 916-927-1488
Mailing address:
  • Phone: 916-927-3178
  • Fax: 916-927-1488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN A ROONEY
Title or Position: PRESIDENT
Credential: MD
Phone: 916-927-3178