Provider Demographics
NPI:1871605642
Name:TROCHET, GLENNAH (MD)
Entity type:Individual
Prefix:
First Name:GLENNAH
Middle Name:
Last Name:TROCHET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GLENNAH
Other - Middle Name:
Other - Last Name:RUIZ-VALERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:633 46TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3125
Mailing Address - Country:US
Mailing Address - Phone:916-736-3560
Mailing Address - Fax:
Practice Address - Street 1:633 46TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3125
Practice Address - Country:US
Practice Address - Phone:916-736-3560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG45398207Q00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine