Healthcare Provider Details

I. General information

NPI: 1346178985
Provider Name (Legal Business Name): STACEY TAING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5512 DANJAC CIR
SACRAMENTO CA
95822-2458
US

IV. Provider business mailing address

5512 DANJAC CIR
SACRAMENTO CA
95822-2458
US

V. Phone/Fax

Practice location:
  • Phone: 916-601-1272
  • Fax:
Mailing address:
  • Phone: 916-601-1272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number5323
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: