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General NPI Number Information
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NPI Number | 1750004420
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Entity Type | Individual
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Provider Name | JESSICA SIADOR CATANGHAL NP
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Gender | Female
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 10/10/2022
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Provider Practice Location Address
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Address Line | 2315 STOCKTON BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95817-2201
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Country | US
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Telephone | 916-734-2145
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Fax |
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Provider Business Mailing Address
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Address Line | 6055 PICKFORD PL APT 9
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City | LOS ANGELES
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State | CA
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Zip | 90035-4534
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Country | US
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Telephone | 916-705-2545
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 95021742
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License Number State | CA
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