Healthcare Provider Details

I. General information

NPI: 1134678089
Provider Name (Legal Business Name): MAKENZIE SAXE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2016
Last Update Date: 06/21/2022
Certification Date: 06/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1526 PLUMAS CT STE 400
YUBA CITY CA
95991-2961
US

IV. Provider business mailing address

1008 FERNWOOD ST
W SACRAMENTO CA
95691-3748
US

V. Phone/Fax

Practice location:
  • Phone: 530-777-3547
  • Fax: 530-777-3084
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA56900
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: