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General NPI Number Information
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NPI Number | 1396080677
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Entity Type | Individual
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Provider Name | ILONA TIMOFEY ASW
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Gender | Female
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Dates
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Enumeration Date | 11/28/2012
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 2241 HARVARD ST
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City | SACRAMENTO
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State | CA
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Zip | 95815-3331
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Country | US
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Telephone | 916-978-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 5107 HOOVER ST
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City | NORTH HIGHLANDS
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State | CA
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Zip | 95660-5460
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Country | US
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Telephone | 916-833-2238
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | D7288668
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License Number State | CA
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