Healthcare Provider Details

I. General information

NPI: 1801599196
Provider Name (Legal Business Name): SAVIE HEALTH CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 04/08/2023
Certification Date: 04/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 E OCEAN AVE STE 2
LOMPOC CA
93436-2500
US

IV. Provider business mailing address

1111 E OCEAN AVE STE 2
LOMPOC CA
93436-2500
US

V. Phone/Fax

Practice location:
  • Phone: 805-743-4776
  • Fax:
Mailing address:
  • Phone: 805-743-4776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERYN SHUGART
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 805-743-4776