Basic Information
| Provider Information | |||||||||
| NPI: | 1821195074 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAATHOFF | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3001 DOUGLAS BLVD | ||||||||
| Address2: | #325 | ||||||||
| City: | ROSEVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956613851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9162419844 | ||||||||
| FaxNumber: | 9162419845 | ||||||||
| Practice Location | |||||||||
| Address1: | 3001 DOUGLAS BLVD | ||||||||
| Address2: | 325 | ||||||||
| City: | ROSEVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956613851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167748300 | ||||||||
| FaxNumber: | 9167747145 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 03/09/2015 | ||||||||
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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 | 363L00000X | NP12681 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | RN292723 | 05 | CA | MEDICAID |