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General NPI Number Information
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NPI Number | 1073646576
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Entity Type | Individual
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Provider Name | SUZY RATTARO WAHLBORG RN344470
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Gender | Female
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 500 JEFFERSON BLVD STE B170
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City | WEST SACRAMENTO
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State | CA
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Zip | 95605-2393
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Country | US
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Telephone | 916-375-6380
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Fax |
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Provider Business Mailing Address
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Address Line | 2907 MUIR WAY
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City | SACRAMENTO
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State | CA
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Zip | 95818-3652
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Country | US
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Telephone | 916-375-6380
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 344470
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License Number State | CA
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