Healthcare Provider Details

I. General information

NPI: 1932395548
Provider Name (Legal Business Name): SACRAMENTO WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 09/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 SECRET RIVER DR SUITE C
SACRAMENTO CA
95831
US

IV. Provider business mailing address

1212 ROSE TREE WAY
SACRAMENTO CA
95831
US

V. Phone/Fax

Practice location:
  • Phone: 916-391-8188
  • Fax: 916-399-4885
Mailing address:
  • Phone: 916-391-8188
  • Fax: 916-399-4885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. LENA F CHENG
Title or Position: SECRETARY
Credential:
Phone: 916-601-3553