Provider Demographics
NPI:1669011003
Name:PALOMERA VELAZQUEZ, ATALIA MADAI
Entity Type:Individual
Prefix:
First Name:ATALIA
Middle Name:MADAI
Last Name:PALOMERA VELAZQUEZ
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 1:8949 RED LEAF WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-4013
Mailing Address - Country:US
Mailing Address - Phone:559-967-6911
Mailing Address - Fax:
Practice Address - Street 1:3800 WATT AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-2670
Practice Address - Country:US
Practice Address - Phone:559-967-6911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator