Provider Demographics
NPI:1639463144
Name:OPPEZZO, BETSY THERESA (PA-C, RD, MSPAS)
Entity Type:Individual
Prefix:MS
First Name:BETSY
Middle Name:THERESA
Last Name:OPPEZZO
Suffix:
Gender:F
Credentials:PA-C, RD, MSPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1755 COURT ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1721
Practice Address - Country:US
Practice Address - Phone:530-247-8800
Practice Address - Fax:530-241-1174
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1098156363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant