Healthcare Provider Details

I. General information

NPI: 1750952099
Provider Name (Legal Business Name): DEBORAH JEAN ACKER JD, MSN, CNM, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

2710 GATEWAY OAKS DR
SACRAMENTO CA
95833-3505
US

IV. Provider business mailing address

2040 BUNKHOUSE CT
PLACERVILLE CA
95667-8900
US

V. Phone/Fax

Practice location:
  • Phone: 650-575-5452
  • Fax:
Mailing address:
  • Phone: 650-575-5452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number257
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP1700X
TaxonomyPerinatal Registered Nurse
License NumberN295625
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: