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General NPI Number Information
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NPI Number | 1730933532
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Entity Type | Individual
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Provider Name | DEINA MARIE ZOE PAVON
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Gender | Female
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Dates
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Enumeration Date | 04/16/2024
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 8950 CAL CENTER DR STE 340
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City | SACRAMENTO
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State | CA
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Zip | 95826-3225
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Country | US
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Telephone | 831-202-7672
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Fax |
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Provider Business Mailing Address
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Address Line | 401 ROLAND WAY STE 100
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City | OAKLAND
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State | CA
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Zip | 94621-2034
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Country | US
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Telephone |
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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