Provider Information for 1891899027
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PATRICICA SUMLIN
Sex: Female
NPI: 1891899027
Last Updated: 2019-07-25
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1891899027 | ||||||||||||||||
| Enumeration Date | 2006-09-08 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 1105 SHEFFIELD CT STOCKTON, CA 95210-1458 United States Phone: | Fax: | ||||||||||||||||
| Primary Practice Address | 2220 WATT AVE STE B SACRAMENTO, CA 95825-0505 United States Phone: 916-485-6500 | Fax:916-485-6814 | ||||||||||||||||
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