Healthcare Provider Details

I. General information

NPI: 1659282192
Provider Name (Legal Business Name): TANYA RANAE LAWRENCE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2507 NORTHVIEW DR
SACRAMENTO CA
95833-2129
US

IV. Provider business mailing address

2507 NORTHVIEW DR
SACRAMENTO CA
95833-2129
US

V. Phone/Fax

Practice location:
  • Phone: 270-200-4077
  • Fax: 270-238-6320
Mailing address:
  • Phone: 270-200-4077
  • Fax: 270-238-6320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246R00000X
TaxonomyPathology Technician
License NumberCPT-02340094
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: