Healthcare Provider Details

I. General information

NPI: 1528994092
Provider Name (Legal Business Name): KAYLA L BLADECKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 48TH ST
SACRAMENTO CA
95817-1541
US

IV. Provider business mailing address

7540 SAN SABANA RD
DUBLIN CA
94568-2246
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2145
  • Fax:
Mailing address:
  • Phone: 510-342-4966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: