Individual provider · NPI-1

Herma Joey Echavez Bag-Ao, APN

Nurse Practitioner · Roseville, CA

NPI number1821561267
StatusActive
Last updated in NPPESDec 10, 2019

Details

NPI
1821561267
Entity type
Individual (NPI-1)
Name
Mrs. Herma Joey Echavez Bag-Ao
Credential
APN
Sex
Female
Sole proprietor
Yes
Enumeration date
Jan 8, 2019
Certification date
Dec 10, 2019
Last updated
Dec 10, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363L00000X Nurse Practitioner95010586CAYes

Practice location

701 Pleasant Grove Blvd Ste 125
Roseville, CA 95678-6194

Phone 916-784-7700

Mailing address

701 Pleasant Grove Blvd
Ste 125
Roseville, CA 95678-6194

Phone 630-915-3467

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