Jeremy Joseph Ahearn

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Elk Grove, CA

NPI 1336870542 · NPPES record last updated Jun 19, 2022

Key facts

NPI
1336870542
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
9700 W Taron Dr
Elk Grove, CA 95757-8145
Phone
(916) 686-7300
NPI assigned
Jun 19, 2022
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

9700 W Taron Dr
Elk Grove, CA 95757-8145

Mailing address

822 The Dalles Ave
Sunnyvale, CA 94087-4149
Phone (408) 245-2558

Other providers in Elk Grove, CA

All providers in Elk Grove, CA · Student in an Organized Health Care Education/Training Program in California

Sources for this page

Verify at the official NPI Registry.