Individual provider · Type 1 NPI

Ly Kong Pheng Jalao

Primary Care Nurse Practitioner · Sacramento, CA

NPI number 1952884124 Active

Practice location

2200 Del Paso Blvd
Sacramento, CA 95815-3102

Call (916) 642-1890 Map

Mailing address

6817 E Lane Ave
Fresno, CA 93727-5814

Specialties and licenses

Taxonomy	Code	License
Primary Care Nurse Practitioner Primary	363LP2300X	NP95009751 (CA)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1952884124

Ly Kong Pheng Jalao's National Provider Identifier is 1952884124, issued on Sep 12, 2018. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Sacramento, CA. The record was last updated on Sep 12, 2018.