MEDICARE: DR. FELISA PADUA TACATA M.D.

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	2084P0800X	Psychiatry Physician	A94819	CA

General Provider Information

NPI Number	:	1427049162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FELISA PADUA TACATA M.D.

Provider Business Mailing Address
First Line	:	2701 DEL PASO RD
Second Line	:	# 130-239
City	:	SACRAMENTO
State	:	CA
Zip	:	95835-2305
Country	:	US
Telephone Number	:	916-486-7555
Fax Number	:	916-486-7557

Provider Business Practice Location Address
First Line	:	2951 FULTON AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-4909
Country	:	US
Telephone Number	:	916-486-7555
Fax Number	:	916-486-7557

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	01/02/2020

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