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Tatiana Monique Hurtado

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

2200 Del Paso Blvd, Sacramento, CA 95815-3102

PECOS Enrollment

This provider is enrolled in PECOS as TATIANA HURTADO.

Based on the most recent information from CMS, provider Tatiana Monique Hurtado is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1003457565
Provider Type
Individual
Full Name
Hurtado, Tatiana Monique
Credential
PHYSICIAN ASSISTANT

Gender
Female
Sole Proprietor
No
Enumeration Date
10/4/2019
Last Updated
10/4/2019

Contact Information

Practice Location

2200 Del Paso Blvd, Sacramento, CA 95815-3102

(916) 924-7988

Unlisted Fax

Mailing Location

246 Cadillac Drive #110, Sacramento, CA 95825

(559) 801-7062

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Tatiana Monique Hurtado

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Vogler, Laura C.

Lord, Kory

Michalsky, Mikayla

Goldfarb, David

Hare, Yuliya

Patel, Ekta

Kaovorakarn, Evelyn Amber

Samimi, Marjon Homeyra

Rosselli, Jordanna

Chhun, May