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General NPI Number Information
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NPI Number | 1528204476
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Entity Type | Organization
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Legal Business Name | JOAN MILLER MORAN
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Dates
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Enumeration Date | 12/24/2008
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Last Update Date | 12/24/2008
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Provider Practice Location Address
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Address Line | 8665 FLORIN RD #98
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City | SACRAMENTO
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State | CA
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Zip | 95828-2640
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Country | US
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Telephone | 916-383-2519
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Fax |
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Provider Business Mailing Address
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Address Line | 8665 FLORIN RD #98
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City | SACRAMENTO
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State | CA
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Zip | 95828
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Country | US
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Telephone | 916-383-2519
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Fax |
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Authorized Official
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Title or Position | LVN
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Name | MRS. JOAN MILLER MORAN
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Credential |
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Telephone | 916-383-2519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | VN69670
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License Number State | CA
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