Healthcare Provider Details

I. General information

NPI: 1073645636
Provider Name (Legal Business Name): MS. SARAHJANE DALLEY-LINCOLN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9343 TECH CENTER DR SECOND FLOOR
SACRAMENTO CA
95826-2563
US

IV. Provider business mailing address

3555 EL RICON WAY
SACRAMENTO CA
95864-2914
US

V. Phone/Fax

Practice location:
  • Phone: 916-955-4322
  • Fax:
Mailing address:
  • Phone: 916-879-4679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number75322
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW75322
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: