Healthcare Provider Details

I. General information

NPI: 1083493787
Provider Name (Legal Business Name): HANNAH NOELLE GUMM CF-RPE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2023
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2033 HOWE AVE STE 160
SACRAMENTO CA
95825-0199
US

IV. Provider business mailing address

9812 OLD WINERY PL STE 21
SACRAMENTO CA
95827-1732
US

V. Phone/Fax

Practice location:
  • Phone: 916-485-6711
  • Fax: 916-679-3100
Mailing address:
  • Phone: 916-485-6711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number18179
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: