Individual provider · NPI-1

Nathan Botts

Community Health Worker · Roseville, CA

NPI number1144913567
StatusActive
Last updated in NPPESNov 1, 2023

Details

NPI
1144913567
Entity type
Individual (NPI-1)
Name
Nathan Botts
Sex
Male
Sole proprietor
No
Enumeration date
May 31, 2023
Certification date
Nov 1, 2023
Last updated
Nov 1, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
172V00000X Community Health Worker––Yes

Practice location

1358 Blue Oaks Blvd. #300
Roseville, CA 95678

Phone 916-899-4920

Mailing address

1163 Sinclair Way
Roseville, CA 95747

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