Healthcare Provider Details

I. General information

NPI: 1366395220
Provider Name (Legal Business Name): LENA J ACKER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 JESSIE AVE
SACRAMENTO CA
95838-2608
US

IV. Provider business mailing address

15552 TOPSPIN WAY
RANCHO MURIETA CA
95683-8810
US

V. Phone/Fax

Practice location:
  • Phone: 279-297-5087
  • Fax: 279-201-6066
Mailing address:
  • Phone: 279-297-5087
  • Fax: 279-201-6066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95039057
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: