MEDICARE: KATIE H AGUILAR

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	363L00000X	Nurse Practitioner	NP95022662	CA

General Provider Information

NPI Number	:	1427766963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE H AGUILAR

Provider Business Mailing Address
First Line	:	2240 LAKE WASHINGTON BLVD STE 130
Second Line	:
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95691-6424
Country	:	US
Telephone Number	:	916-617-2331
Fax Number	:

Provider Business Practice Location Address
First Line	:	2240 LAKE WASHINGTON BLVD STE 130
Second Line	:
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95691-6424
Country	:	US
Telephone Number	:	916-617-2331
Fax Number	:

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

Provider Enumeration Date	:	11/14/2022
Last Update Date	:	11/14/2022

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Directions to “ KATIE H AGUILAR ” Practice Location

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