Healthcare Provider Details

I. General information

NPI: 1528440708
Provider Name (Legal Business Name): ADRIENNE HOYT-AUSTIN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2015
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2516 STOCKTON BLVD
SACRAMENTO CA
95817-2208
US

IV. Provider business mailing address

2103 STOCKTON BLVD
SACRAMENTO CA
95817-1354
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-5387
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0116028530
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A17113
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: