Healthcare Provider Details
I. General information
NPI: 1265569917
Provider Name (Legal Business Name): RIVER OAK CENTER FOR CHILDREN
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5030 EL CAMINO AVE
CARMICHAEL CA
95608-4650
US
IV. Provider business mailing address
5030 EL CAMINO AVE
CARMICHAEL CA
95608-4650
US
V. Phone/Fax
- Phone: 916-609-4916
- Fax: 916-609-5160
- Phone: 916-609-4916
- Fax: 916-609-5160
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
DEBRA
ANN
ESCALERA
Title or Position: FAMILY ADVOCATE
Credential:
Phone: 916-609-4916