Healthcare Provider Details

I. General information

NPI: 1245795822
Provider Name (Legal Business Name): MAFALDA IRENE LOZANO DELGADO PMHNP - BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2019
Last Update Date: 04/05/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 N ST # 9875
SACRAMENTO CA
95816-5712
US

IV. Provider business mailing address

2108 N ST # 9875
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 916-655-0920
  • Fax: 916-581-8690
Mailing address:
  • Phone: 916-655-0920
  • Fax: 916-581-8690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP95032222
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95073242
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: