Healthcare Provider Details

I. General information

NPI: 1457501157
Provider Name (Legal Business Name): NATALYA BOKOCH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 06/24/2021
Certification Date: 06/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7225 E SOUTHGATE DR
SACRAMENTO CA
95823-2620
US

IV. Provider business mailing address

6127 FAIR OAKS BLVD
CARMICHAEL CA
95608-4818
US

V. Phone/Fax

Practice location:
  • Phone: 916-394-1000
  • Fax:
Mailing address:
  • Phone: 916-974-8090
  • Fax: 916-974-7851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP17760
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: