Healthcare Provider Details

I. General information

NPI: 1871104877
Provider Name (Legal Business Name): AIMEE YRIGAN AQUITANIA ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 HOWE AVE STE 50
SACRAMENTO CA
95825-4670
US

IV. Provider business mailing address

5500 MINER WAY
SACRAMENTO CA
95820-5687
US

V. Phone/Fax

Practice location:
  • Phone: 916-457-7424
  • Fax:
Mailing address:
  • Phone: 916-764-6066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95085142
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number95085142
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: