Basic Information
| Provider Information | |||||||||
| NPI: | 1679598577 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | NAVAS | ||||||||
| FirstName: | EBBA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1860 PENNSYLVANIA AVE | ||||||||
| Address2: | STE 145 NORTHBAY NEONATOLOGY AND ASSOCIATES INC | ||||||||
| City: | FAIRFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945333590 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8882700340 | ||||||||
| FaxNumber: | 8882700331 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 HOSPITAL DR | ||||||||
| Address2: | SUTTER SOLANO MEDICAL CENTER | ||||||||
| City: | VALLEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95489 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7075545226 | ||||||||
| FaxNumber: | 7075545102 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN637822 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | NA3116 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 637822 | 01 | RN | OTHER | 3116 | 01 | NA | OTHER |