Healthcare Provider Details

I. General information

NPI: 1013083807
Provider Name (Legal Business Name): COUNTY OF SACRAMENTO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2006
Last Update Date: 11/29/2020
Certification Date: 11/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5747 WATT AVE
NORTH HIGHLANDS CA
95660-4751
US

IV. Provider business mailing address

7001A EAST PKWY SUITE 400
SACRAMENTO CA
95823-2501
US

V. Phone/Fax

Practice location:
  • Phone: 916-876-8000
  • Fax: 916-876-7470
Mailing address:
  • Phone: 916-875-4948
  • Fax: 916-875-6970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: UMA ZYKOFSKY
Title or Position: DEPUTY DIRECTOR
Credential:
Phone: 916-875-7070