Healthcare Provider Details

I. General information

NPI: 1467238279
Provider Name (Legal Business Name): CHELSEA O'DELL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2023
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 K ST STE 200
SACRAMENTO CA
95816-5118
US

IV. Provider business mailing address

2801 K ST STE 200
SACRAMENTO CA
95816-5118
US

V. Phone/Fax

Practice location:
  • Phone: 916-779-1160
  • Fax:
Mailing address:
  • Phone: 916-779-1160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License NumberNP95026914
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: