MEDICARE: COUNTY OF SUTTER

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1477954535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF SUTTER

Provider Business Mailing Address
First Line	:	1965 LIVE OAK BLVD STE A
Second Line	:	PO BOX 1520
City	:	YUBA CITY
State	:	CA
Zip	:	95991-8850
Country	:	US
Telephone Number	:	530-822-7200
Fax Number	:

Provider Business Practice Location Address
First Line	:	545 GARDEN HWY STE A-1&A2
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95991-6338
Country	:	US
Telephone Number	:	530-822-7263
Fax Number	:

Authorized Official
Title or Position	:	ASSISTANT HHS DIRECTOR
Name	:	RICK BINGHAM
Credential	:	LMFT
Telephone Number	:	530-822-7327

Provider Enumeration Date	:	09/09/2014
Last Update Date	:	09/09/2019

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Directions to “COUNTY OF SUTTER ” Practice Location

Language	Start Address	Practice Location

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