Healthcare Provider Details

I. General information

NPI: 1205768686
Provider Name (Legal Business Name): MARY ELIZABETH FELIX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3777 VACA VALLEY PKWY # B
VACAVILLE CA
95688-9430
US

IV. Provider business mailing address

3777 VACA VALLEY PKWY # B
VACAVILLE CA
95688-9430
US

V. Phone/Fax

Practice location:
  • Phone: 707-640-9700
  • Fax: 707-949-9948
Mailing address:
  • Phone: 707-640-9700
  • Fax: 707-949-9948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number486804166
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: