Provider Demographics
NPI:1578620241
Name:SAKAMOTO, PAMELA MARY (BSN, PHN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:MARY
Last Name:SAKAMOTO
Suffix:
Gender:F
Credentials:BSN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7621 WOODCHUCK WAY
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-2533
Mailing Address - Country:US
Mailing Address - Phone:916-600-9015
Mailing Address - Fax:916-723-9265
Practice Address - Street 1:275 BECK AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6804
Practice Address - Country:US
Practice Address - Phone:707-784-8654
Practice Address - Fax:707-421-7484
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA272783163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA272783OtherRN LICENSE NUMBER