Provider Demographics
NPI:1831517515
Name:SACRAMENTO PERMANENT COSMETICS
Entity type:Organization
Organization Name:SACRAMENTO PERMANENT COSMETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEMANENT COSMETIC/MEDICAL TATTOOIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBI
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:CPCP
Authorized Official - Phone:916-961-6263
Mailing Address - Street 1:8518 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3809
Mailing Address - Country:US
Mailing Address - Phone:916-961-6263
Mailing Address - Fax:916-961-6277
Practice Address - Street 1:8518 MADISON AVE
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3809
Practice Address - Country:US
Practice Address - Phone:916-961-6263
Practice Address - Fax:916-961-6277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty