Healthcare Provider Details

I. General information

NPI: 1700793049
Provider Name (Legal Business Name): HANA TAYE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 JESSIE AVE
SACRAMENTO CA
95838-2609
US

IV. Provider business mailing address

8822 ARISTON LN
ELK GROVE CA
95758-5545
US

V. Phone/Fax

Practice location:
  • Phone: 916-668-0683
  • Fax:
Mailing address:
  • Phone: 916-752-7504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95038665
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: