Provider Demographics
NPI:1275644718
Name:COMBS, LEVI AARON
Entity type:Individual
Prefix:MR
First Name:LEVI
Middle Name:AARON
Last Name:COMBS
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 1:126 FOUNTAIN OAKS CIR APT 199
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3971
Mailing Address - Country:US
Mailing Address - Phone:559-415-5399
Mailing Address - Fax:
Practice Address - Street 1:3628 MADISON AVE STE 6
Practice Address - Street 2:
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660-5070
Practice Address - Country:US
Practice Address - Phone:916-388-3231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26900167G00000X
225800000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No167G00000XNursing Service ProvidersLicensed Psychiatric Technician
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist