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NPI Code Detail

MEDICARE: URSULA M MACK

MEDICARE: URSULA M MACK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1033041157
Entity Type Code : Individual
Provider Name (Legal Business Name) : URSULA M MACK
Provider Business Mailing Address
First Line : 7201 SUNCREEK WAY
Second Line :
City : ORANGEVALE
State : CA
Zip : 95662-2435
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3555 AUBURN BLVD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95821-2005
Country : US
Telephone Number : 916-482-2370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2026
Last Update Date : 06/02/2026

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Directions to “ URSULA M MACK ” Practice Location

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