Provider Demographics
NPI:1093088577
Name:SAEL, TATY L
Entity Type:Individual
Prefix:MRS
First Name:TATY
Middle Name:L
Last Name:SAEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 DEL VISTA CIR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5635
Mailing Address - Country:US
Mailing Address - Phone:916-690-7243
Mailing Address - Fax:916-393-2527
Practice Address - Street 1:78 DEL VISTA CIR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5635
Practice Address - Country:US
Practice Address - Phone:916-690-7243
Practice Address - Fax:916-393-2527
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347003426310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility