Provider Demographics
NPI:1437361680
Name:TALENTO, FERDIE
Entity type:Individual
Prefix:
First Name:FERDIE
Middle Name:
Last Name:TALENTO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11121 SUN CENTER DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-6161
Mailing Address - Country:US
Mailing Address - Phone:916-631-0112
Mailing Address - Fax:916-631-1652
Practice Address - Street 1:11121 SUN CENTER DR
Practice Address - Street 2:SUITE G
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-6161
Practice Address - Country:US
Practice Address - Phone:916-631-0112
Practice Address - Fax:916-631-1652
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMTA 40677246RM2200X
CA1190247200000X
246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other