Healthcare Provider Details

I. General information

NPI: 1124859632
Provider Name (Legal Business Name): KRYSTINA PATEL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2024
Last Update Date: 08/08/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SCRIPPS DR
SACRAMENTO CA
95825-6206
US

IV. Provider business mailing address

1 SCRIPPS DR
SACRAMENTO CA
95825-6206
US

V. Phone/Fax

Practice location:
  • Phone: 916-927-1114
  • Fax:
Mailing address:
  • Phone: 916-802-2593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95031527
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: