Healthcare Provider Details

I. General information

NPI: 1972876506
Provider Name (Legal Business Name): SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2012
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 CELESTE DR STE 140
MODESTO CA
95355-2437
US

IV. Provider business mailing address

4830 BUSINESS CENTER DR STE 140
FAIRFIELD CA
94534-1797
US

V. Phone/Fax

Practice location:
  • Phone: 209-571-1055
  • Fax: 209-342-4039
Mailing address:
  • Phone: 855-771-0328
  • Fax: 707-863-9043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARK K MCPHERSON
Title or Position: CEO
Credential:
Phone: 707-864-4660