Healthcare Provider Details

I. General information

NPI: 1962618496
Provider Name (Legal Business Name): SUETFEI NG WON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUETFEI NG WON RN, MSN, ACNP-BC

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 01/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 STOCKTON BLVD HOUSESTAFF BUILDING
SACRAMENTO CA
95817-2201
US

IV. Provider business mailing address

2315 STOCKTON BLVD HOUSESTAFF BUILDING
SACRAMENTO CA
95817-2201
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-7211
  • Fax: 916-734-0432
Mailing address:
  • Phone: 916-734-7211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number11502
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: