Provider Demographics
NPI:1548747520
Name:SOM-ANYA, OBY (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:OBY
Middle Name:
Last Name:SOM-ANYA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5960 S LAND PARK DR STE 1009
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-3313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1352 COLUSA AVENUE, STE C
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-9147
Practice Address - Country:US
Practice Address - Phone:530-618-8178
Practice Address - Fax:530-618-8031
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008615363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily