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General NPI Number Information
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NPI Number | 1326794355
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Entity Type | Organization
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Legal Business Name | ROSEVILLE FOOT AND ANKLE PC
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Dates
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Enumeration Date | 02/28/2022
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 906 CIRBY WAY STE 100
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City | ROSEVILLE
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State | CA
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Zip | 95661-4475
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Country | US
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Telephone | 916-300-9633
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Fax |
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Provider Business Mailing Address
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Address Line | 906 CIRBY WAY STE 100
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City | ROSEVILLE
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State | CA
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Zip | 95661-4475
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Country | US
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Telephone | 916-243-5033
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KENTSTON CRIPE
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Credential |
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Telephone | 916-300-9633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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