Provider Demographics
NPI:1275644718
Name:COMBS, LEVI AARON
Entity Type:Individual
Prefix:MR
First Name:LEVI
Middle Name:AARON
Last Name:COMBS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 W EL CAMINO AVE APT 455
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95833-1481
Mailing Address - Country:US
Mailing Address - Phone:916-922-8053
Mailing Address - Fax:
Practice Address - Street 1:2045 W EL CAMINO AVE APT 455
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95833-1481
Practice Address - Country:US
Practice Address - Phone:916-922-8053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26900167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician