Individual provider · NPI-1
Jerry Ydel Abengana
Nursing Home Administrator · Rancho Cordova, CA
NPI number1508647884
StatusActive
Last updated in NPPESOct 11, 2023
Details
- NPI
- 1508647884
- Entity type
- Individual (NPI-1)
- Name
- Jerry Ydel Abengana
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 11, 2023
- Certification date
- Oct 11, 2023
- Last updated
- Oct 11, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 376G00000X | Nursing Home Administrator | 342701204 | CA | Yes |
Practice location
3469 Durello CirRancho Cordova, CA 95670-6913
Phone 916-476-3555
Mailing address
3469 Durello CirRancho Cordova, CA 95670-6913
Phone 916-476-3555
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