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NPI Code Detail

MEDICARE: MS. ELENITSA EVYENIA SEBAT PA-C, M.S.

MEDICARE: MS. ELENITSA EVYENIA SEBAT PA-C, M.S.
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
1363A00000XPhysician Assistant20415CA

General Provider Information

NPI Number : 1538493689
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELENITSA EVYENIA SEBAT PA-C, M.S.
Provider Business Mailing Address
First Line : 4256 SUFFOLK WAY
Second Line :
City : EL DORADO HILLS
State : CA
Zip : 95762-4117
Country : US
Telephone Number : 312-330-3102
Fax Number :
Provider Business Practice Location Address
First Line : 3301 C ST STE 1300
Second Line :
City : SACRAMENTO
State : CA
Zip : 95816-3370
Country : US
Telephone Number : 916-734-6111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2009
Last Update Date : 12/09/2021

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