Healthcare Provider Details

I. General information

NPI: 1093799660
Provider Name (Legal Business Name): JEFF SCOTT KASTEN N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2316 STOCKTON BLVD
SACRAMENTO CA
95817-2202
US

IV. Provider business mailing address

8466 COBBLE CREEK LN
ORANGEVALE CA
95662-3868
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-5538
  • Fax: 916-734-1660
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number10997
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: