Active Life Wound Clinic A Professional Nursing Corporation
Nurse Practitioner
2 Scripps Dr Ste 202, Sacramento
California, 95825-6207
916-436-3015 Active Life Wound Clinic A Professional Nursing Corporation is an authorized DME supplier for medicare equipment and products.Active Life Wound Clinic A Professional Nursing Corporation is a Nurse Practitioner in Sacramento, California. It is located at 2 Scripps Dr Ste 202, Sacramento and it's customer support contact number is 916-436-3015. The authorized person of Active Life Wound Clinic A Professional Nursing Corporation is Jeff Souza who is President of this DME and his contact number is 916-436-3015. Active Life Wound Clinic A Professional Nursing Corporation accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Active Life Wound Clinic A Professional Nursing Corporation is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
DME Supplier Details:
Active Life Wound Clinic A Professional Nursing Corporation type, location, contact phone number and fax are as below. Patients can directly walkin or can call on the below given customer support phone number for enquiries.
| Name: | Active Life Wound Clinic A Professional Nursing Corporation |
| Type: | Nurse Practitioner |
| Location: | 2 Scripps Dr Ste 202, Sacramento, California, 95825-6207 |
| Phone: | 916-436-3015 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this supplier is as below. Person's position and contact details are also mentioned below.
| Name: | Jeff Souza |
| Position: | President |
| Contact Number: | 916-436-3015 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given supplier are as mentioned below.
| NPI Number: | 1801253323 |
| NPI Enumeration Date: | 28 Jan, 2016 |
| NPI Last Update On: | 15 Apr, 2025 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Active Life Wound Clinic A Professional Nursing Corporation are as mentioned below.
| Specialization | License Number | State | Status | |
| Nurse Practitioner | | | Primary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
Medicare Enrollment:
Active Life Wound Clinic A Professional Nursing Corporation is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 9436419017 | O20180130000241 | Active Life Wound Clinic A Professional Nursing Corporation | PART B SUPPLIER - CLINIC/GROUP PRACTICE |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Po Box 661587, Sacramento, California |
| Zip: | 95866-1587 |
| Phone Number: | -- |
Patients can reach Active Life Wound Clinic A Professional Nursing Corporation at
2 Scripps Dr Ste 202, Sacramento, California or can
call on customer care at 916-436-3015.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.