Provider Demographics
NPI:1083319966
Name:MALBROUGH, TOI SAN
Entity type:Individual
Prefix:
First Name:TOI SAN
Middle Name:
Last Name:MALBROUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9340 E STOCKTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1563
Mailing Address - Country:US
Mailing Address - Phone:916-509-8198
Mailing Address - Fax:916-509-8199
Practice Address - Street 1:9340 E STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-1563
Practice Address - Country:US
Practice Address - Phone:916-509-8198
Practice Address - Fax:916-509-8199
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No172V00000XOther Service ProvidersCommunity Health Worker