Provider Demographics
NPI:1770657876
Name:ORELLANA, ISABEL (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:ORELLANA
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 CREEKSIDE DR
Mailing Address - Street 2:STE 1300
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3445
Mailing Address - Country:US
Mailing Address - Phone:916-984-7860
Mailing Address - Fax:916-784-7858
Practice Address - Street 1:3000 Q ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-7058
Practice Address - Country:US
Practice Address - Phone:916-733-3377
Practice Address - Fax:916-733-5380
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPA17607207Q00000X
CAPA17607363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPA17607Medicare ID - Type Unspecified