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General NPI Number Information
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NPI Number | 1487124657
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Entity Type | Individual
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Provider Name | JACLYN SABANOVICH FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/30/2018
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Last Update Date | 11/20/2020
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Provider Practice Location Address
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Address Line | 2216 BUENAVENTURA BLVD
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City | REDDING
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State | CA
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Zip | 96001-3838
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Country | US
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Telephone | 530-338-0002
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Fax |
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Provider Business Mailing Address
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Address Line | 2216 BUENAVENTURA BLVD STE B
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City | REDDING
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State | CA
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Zip | 96001-3838
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Country | US
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Telephone | 530-338-0002
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Fax | 530-768-1271
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F07180575
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | F07180575
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License Number State | CA
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