Provider Demographics
NPI:1588350854
Name:AKILO, VICTORIA IYABO (RN)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:IYABO
Last Name:AKILO
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 1:9083 RICHBOROUGH WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1304
Mailing Address - Country:US
Mailing Address - Phone:916-502-5065
Mailing Address - Fax:
Practice Address - Street 1:9083 RICHBOROUGH WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-1304
Practice Address - Country:US
Practice Address - Phone:916-502-5065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA602762163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical