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General NPI Number Information
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NPI Number | 1871677047
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Entity Type | Individual
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Provider Name | CYRIL MARAVILLAS MOYA CRNA
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Gender | Male
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 6600 BRUCEVILLE RD
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City | SACRAMENTO
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State | CA
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Zip | 95823-4671
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Country | US
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Telephone | 916-688-2574
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Fax |
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Provider Business Mailing Address
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Address Line | 250 MCADOO DR APT 311
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City | FOLSOM
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State | CA
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Zip | 95630-7517
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Country | US
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Telephone | 916-985-6096
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 650221
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3181
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License Number State | CA
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