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NPI Code Detail

MEDICARE: AUDREY HART

MEDICARE: AUDREY HART
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
1167G00000XLicensed Psychiatric Technician42926CA

General Provider Information

NPI Number : 1487583357
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDREY HART
Provider Business Mailing Address
First Line : 1085 SANDRINGHAM WAY
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-5321
Country : US
Telephone Number : 916-642-7800
Fax Number : 916-755-4799
Provider Business Practice Location Address
First Line : 1085 SANDRINGHAM WAY
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-5321
Country : US
Telephone Number : 916-642-7800
Fax Number : 916-755-4799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2026
Last Update Date : 05/18/2026

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Directions to “ AUDREY HART ” Practice Location

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