Healthcare Provider Details

I. General information

NPI: 1720157993
Provider Name (Legal Business Name): MARIANA CIOCAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 08/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SCRIPPS DR STE 107
SACRAMENTO CA
95825-6206
US

IV. Provider business mailing address

1 SCRIPPS DR STE 107
SACRAMENTO CA
95825-6206
US

V. Phone/Fax

Practice location:
  • Phone: 916-568-5000
  • Fax: 916-568-5008
Mailing address:
  • Phone: 916-568-5000
  • Fax: 916-568-5008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT18689
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: