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General NPI Number Information
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NPI Number | 1457239758
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Entity Type | Organization
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Legal Business Name | SACRAMENTO SIERRA DERMATOLOGY PC
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 7447 ANTELOPE RD STE 103
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95621-2064
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Country | US
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Telephone | 310-980-9580
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Fax |
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Provider Business Mailing Address
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Address Line | 7447 ANTELOPE RD STE 130
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95621-2064
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Country | US
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Telephone | 310-980-9580
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAUREN P KELLER
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Credential | DO
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Telephone | 310-980-9580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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