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General NPI Number Information
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NPI Number | 1003769357
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Entity Type | Individual
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Provider Name | CARMEL BORGONIA
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Gender |
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Dates
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Enumeration Date | 02/17/2026
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 1221 ANDERSON RD
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City | DAVIS
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State | CA
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Zip | 95616-1846
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Country | US
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Telephone | 530-757-5490
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Fax |
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Provider Business Mailing Address
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Address Line | 3215 LASSIK ST
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691-5238
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Country | US
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Telephone |
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State | CA
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