Healthcare Provider Details

I. General information

NPI: 1366986390
Provider Name (Legal Business Name): TINA BENAVENTE RAMOS MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TINA BENAVENTE RAMOS MSN FNP-C

II. Dates (important events)

Enumeration Date: 12/09/2016
Last Update Date: 01/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 DEL PASO BLVD
SACRAMENTO CA
95815-3102
US

IV. Provider business mailing address

14757 GUADALUPE DR
RANCHO MURIETA CA
95683-9438
US

V. Phone/Fax

Practice location:
  • Phone: 916-924-7988
  • Fax: 916-924-7989
Mailing address:
  • Phone: 916-202-9430
  • Fax: 916-354-1065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95005500
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: