Healthcare Provider Details

I. General information

NPI: 1295500783
Provider Name (Legal Business Name): ALLAN POLENDEY DUMLAO DNP, MS, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2023
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 48TH ST
SACRAMENTO CA
95817-1541
US

IV. Provider business mailing address

2570 48TH ST
SACRAMENTO CA
95817-1541
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2145
  • Fax:
Mailing address:
  • Phone: 916-734-2145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95036477
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: