MEDICARE: ASPIRA FOSTER & FAMILY SERVICES - SACRAMENTO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency		CA

General Provider Information

NPI Number	:	1205970795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPIRA FOSTER & FAMILY SERVICES - SACRAMENTO

Provider Business Mailing Address
First Line	:	9719 LINCOLN VILLAGE DR
Second Line	:	SUITE 401
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-3303
Country	:	US
Telephone Number	:	906-366-1656
Fax Number	:	916-366-0189

Provider Business Practice Location Address
First Line	:	9719 LINCOLN VILLAGE DR
Second Line	:	SUITE 401
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-3303
Country	:	US
Telephone Number	:	906-366-1656
Fax Number	:	916-366-0189

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. VERNON BROWN
Credential	:
Telephone Number	:	650-866-4080

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	08/27/2007

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