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General NPI Number Information
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NPI Number | 1003524893
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Entity Type | Individual
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Provider Name | BLANCA E AVILA NP
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Gender | Female
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Dates
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Enumeration Date | 11/09/2022
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 2 SCRIPPS DR STE 302
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City | SACRAMENTO
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State | CA
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Zip | 95825-6207
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Country | US
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Telephone | 714-472-7942
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Fax |
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Provider Business Mailing Address
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Address Line | 1164 FORMBY WAY
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City | ROSEVILLE
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State | CA
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Zip | 95747-6456
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Country | US
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Telephone | 714-472-7942
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 860482
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95022845
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License Number State | CA
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