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General NPI Number Information
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NPI Number | 1568817617
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Entity Type | Organization
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Legal Business Name | FORENSIC BLOOD SERVICES
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Dates
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Enumeration Date | 04/26/2016
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Last Update Date | 04/26/2016
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Provider Practice Location Address
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Address Line | 5750 IAN CT
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City | SACRAMENTO
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State | CA
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Zip | 95842-2254
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Country | US
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Telephone | 707-540-1225
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Fax | 916-723-5856
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Provider Business Mailing Address
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Address Line | 5750 IAN CT
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City | SACRAMENTO
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State | CA
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Zip | 95842-2254
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Country | US
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Telephone | 707-540-1225
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Fax | 916-723-5856
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Authorized Official
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Title or Position | OWNER
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Name | MS. MONICA LEE MENJIVAR
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Credential | CPA
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Telephone | 707-540-1225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | CPA3892
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License Number State | CA
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