Healthcare Provider Details

I. General information

NPI: 1316519341
Provider Name (Legal Business Name): FRANK ANTHONY MOLINA NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 09/13/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 21ST ST
SACRAMENTO CA
95811-5216
US

IV. Provider business mailing address

2570 48TH ST
SACRAMENTO CA
95817-1541
US

V. Phone/Fax

Practice location:
  • Phone: 916-443-3299
  • Fax:
Mailing address:
  • Phone: 916-734-2145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95018161
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95203167
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: