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General NPI Number Information
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NPI Number | 1063057651
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Entity Type | Individual
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Provider Name | MICHELLE R ANCHETA LPN
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Gender | Female
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Dates
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Enumeration Date | 11/07/2019
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 7240 E SOUTHGATE DR STE G
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City | SACRAMENTO
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State | CA
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Zip | 95823-2627
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Country | US
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Telephone | 916-330-3747
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Fax |
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Provider Business Mailing Address
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Address Line | 7240 E SOUTHGATE DR STE G
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City | SACRAMENTO
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State | CA
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Zip | 95823-2627
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Country | US
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Telephone | 916-765-6438
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LX0639
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License Number State | GU
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Taxonomy #2
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 713340
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License Number State | CA
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