Provider Demographics
NPI:1295255743
Name:RIOS, ELISAPETAVAISALAFAI
Entity type:Individual
Prefix:
First Name:ELISAPETAVAISALAFAI
Middle Name:
Last Name:RIOS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ELISA
Other - Middle Name:
Other - Last Name:UIVAA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2750 SUTTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-1093
Mailing Address - Country:US
Mailing Address - Phone:916-452-3981
Mailing Address - Fax:916-454-5031
Practice Address - Street 1:2750 SUTTERVILLE RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-1024
Practice Address - Country:US
Practice Address - Phone:916-452-3981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion