Healthcare Provider Details

I. General information

NPI: 1366299000
Provider Name (Legal Business Name): SIERRA HEALTH AND WELLNESS CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 COYOTE MOON TRAIL
BANGOR CA
95914
US

IV. Provider business mailing address

9985 FOLSOM BLVD
SACRAMENTO CA
95827-1405
US

V. Phone/Fax

Practice location:
  • Phone: 866-303-6275
  • Fax: 530-430-3067
Mailing address:
  • Phone: 866-303-6275
  • Fax: 530-430-3067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: LIEN THI HOANG
Title or Position: CHIEF REVENUE OFFICER
Credential:
Phone: 702-205-8232