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General NPI Number Information
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NPI Number | 1124694708
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Entity Type | Individual
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Provider Name | KIMBERLY T HOANG
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Gender | Female
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Dates
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Enumeration Date | 06/03/2021
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 4001 J ST
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City | SACRAMENTO
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State | CA
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Zip | 95819-3626
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Country | US
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Telephone | 916-453-4545
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Fax |
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Provider Business Mailing Address
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Address Line | 20 YORK STREET, CB-329
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City | NEW HAVEN
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State | CT
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Zip | 06510-3220
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Country | US
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Telephone | 203-688-4745
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Fax | 203-688-4740
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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 | 95318798
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 95024775
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License Number State | CA
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