MEDICARE: JEAN PAULETTE ALARCON GATMEN

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	363LF0000X	Family Nurse Practitioner	95004470	CA

General Provider Information

NPI Number	:	1679027577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN PAULETTE ALARCON GATMEN

Provider Business Mailing Address
First Line	:	1035 JEFFERSON BLVD STE 1
Second Line	:
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95691-3343
Country	:	US
Telephone Number	:	916-371-3787
Fax Number	:	916-371-3790

Provider Business Practice Location Address
First Line	:	1035 JEFFERSON BLVD STE 1
Second Line	:
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95691-3343
Country	:	US
Telephone Number	:	916-371-3787
Fax Number	:	916-371-3790

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

Provider Enumeration Date	:	08/08/2016
Last Update Date	:	02/24/2022

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