Provider Demographics
NPI:1700083425
Name:MOONEY, PAMELA ENO (RN)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ENO
Last Name:MOONEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 STOCKTON BLVD RM 4302
Mailing Address - Street 2:PATIENT CARE SERVICES UC DAVIS MEDICAL CENTER
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817
Mailing Address - Country:US
Mailing Address - Phone:916-703-3023
Mailing Address - Fax:
Practice Address - Street 1:2315 STOCKTON BLVD RM 4302
Practice Address - Street 2:PATIENT CARE SERVICES UC DAVIS MEDICAL CENTER
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-703-3023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 265096163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics