=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710833686
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GEORGIANA I NATH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/04/2026
-----------------------------------------------------
Last Update Date | 03/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7770 TWIN OAKS AVE
-----------------------------------------------------
City | CITRUS HEIGHTS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95610-0438
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-410-0831
-----------------------------------------------------
Fax | 916-345-0205
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7770 TWIN OAKS AVE
-----------------------------------------------------
City | CITRUS HEIGHTS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95610-0438
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-410-0831
-----------------------------------------------------
Fax | 916-345-0205
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number | 345920114
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------