Healthcare Provider Details

I. General information

NPI: 1093088577
Provider Name (Legal Business Name): MRS. TATY L SAEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2012
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 DEL VISTA CIR
SACRAMENTO CA
95823-5635
US

IV. Provider business mailing address

78 DEL VISTA CIR
SACRAMENTO CA
95823-5635
US

V. Phone/Fax

Practice location:
  • Phone: 916-690-7243
  • Fax: 916-393-2527
Mailing address:
  • Phone: 916-690-7243
  • Fax: 916-393-2527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number347003426
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: