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General NPI Number Information
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NPI Number | 1538022280
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Entity Type | Individual
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Provider Name | MR. ANDRE ALBASON
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Gender | Male
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 10167 MOSAIC WAY
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City | ELK GROVE
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State | CA
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Zip | 95757-5961
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Country | US
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Telephone | 916-897-6912
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Fax |
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Provider Business Mailing Address
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Address Line | 10167 MOSAIC WAY
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City | ELK GROVE
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State | CA
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Zip | 95757-5961
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Country | US
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Telephone | 916-897-6912
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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 | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number | 342701631
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License Number State | CA
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