Healthcare Provider Details

I. General information

NPI: 1669115804
Provider Name (Legal Business Name): SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 05/02/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 LAVA RIDGE CT STE 310
ROSEVILLE CA
95661-2838
US

IV. Provider business mailing address

5099 COMMERCIAL CIR STE 208
CONCORD CA
94520-1374
US

V. Phone/Fax

Practice location:
  • Phone: 800-281-1764
  • Fax:
Mailing address:
  • Phone: 855-771-0328
  • Fax: 707-863-9043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

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