Provider Demographics
NPI:1942060843
Name:SLOCUM, SYDNEY DANIELLE (HCA)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:DANIELLE
Last Name:SLOCUM
Suffix:
Gender:F
Credentials:HCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4694 DUSTY LN
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-9148
Mailing Address - Country:US
Mailing Address - Phone:707-290-9034
Mailing Address - Fax:
Practice Address - Street 1:4694 DUSTY LN
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-9148
Practice Address - Country:US
Practice Address - Phone:707-290-9034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7517353421251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health