Healthcare Provider Details

I. General information

NPI: 1063257491
Provider Name (Legal Business Name): JULIETT BETH PICKETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8233 E STOCKTON BLVD STE A
SACRAMENTO CA
95828-8203
US

IV. Provider business mailing address

8233 E STOCKTON BLVD STE A
SACRAMENTO CA
95828-8203
US

V. Phone/Fax

Practice location:
  • Phone: 916-890-5795
  • Fax: 916-856-0115
Mailing address:
  • Phone: 916-890-5795
  • Fax: 916-856-0115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number10632257491
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: