Healthcare Provider Details
I. General information
NPI: 1659782100
Provider Name (Legal Business Name): JAMIE ELIZABETH ANDERSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/17/2014
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2335 STOCKTON BLVD FL 5
SACRAMENTO CA
95817-2201
US
IV. Provider business mailing address
UC DAVIS DEPARTMENT OF SURGERY 2335 STOCKTON BLVD., 5TH FLOOR
SACRAMENTO CA
95817-2201
US
V. Phone/Fax
- Phone: 916-703-4473
- Fax: 916-734-5633
- Phone: 916-703-4473
- Fax: 916-734-5633
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0120X |
| Taxonomy | Pediatric Surgery Physician |
| License Number | A140553 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: