Provider Demographics
NPI:1669996005
Name:HARVEY, EDEN NICOLE
Entity type:Individual
Prefix:
First Name:EDEN
Middle Name:NICOLE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EDEN
Other - Middle Name:NICOLE
Other - Last Name:COTTRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3943 FIG ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95838-3724
Mailing Address - Country:US
Mailing Address - Phone:530-718-6879
Mailing Address - Fax:
Practice Address - Street 1:3943 FIG ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-3724
Practice Address - Country:US
Practice Address - Phone:530-718-6879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator