Healthcare Provider Details

I. General information

NPI: 1518892298
Provider Name (Legal Business Name): JALONIE HANZY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 COTTAGE WAY STE G2
SACRAMENTO CA
95825-1474
US

IV. Provider business mailing address

3400 COTTAGE WAY STE G2
SACRAMENTO CA
95825-1474
US

V. Phone/Fax

Practice location:
  • Phone: 510-213-8650
  • Fax:
Mailing address:
  • Phone: 510-213-8650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberCPT-02467289
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: