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General NPI Number Information
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NPI Number | 1841724317
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Entity Type | Individual
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Provider Name | LISA VOGUE MACHADO RN, PHN, MSN, FNP
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Gender | Female
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Dates
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Enumeration Date | 04/12/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 4100 E COMMERCE WAY
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City | SACRAMENTO
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State | CA
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Zip | 95834-9500
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Country | US
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Telephone | 916-575-9090
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Fax |
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Provider Business Mailing Address
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Address Line | 3609 PARK RD
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City | SACRAMENTO
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State | CA
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Zip | 95841-4404
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Country | US
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Telephone | 916-612-4130
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95008212
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License Number State | CA
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