MEDICARE: JEFF SCOTT KASTEN N.P.

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
1	363LA2100X	Acute Care Nurse Practitioner	10997	CA

General Provider Information

NPI Number	:	1093799660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFF SCOTT KASTEN N.P.

Provider Business Mailing Address
First Line	:	8466 COBBLE CREEK LN
Second Line	:
City	:	ORANGEVALE
State	:	CA
Zip	:	95662-3868
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2316 STOCKTON BLVD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-2202
Country	:	US
Telephone Number	:	916-734-5538
Fax Number	:	916-734-1660

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	07/08/2007

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