Healthcare Provider Details

I. General information

NPI: 1457146748
Provider Name (Legal Business Name): SACRAMENTO DISTRICT COUNCIL ST. VINCENT DE PAUL SOCIETY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2324 L ST STE 308
SACRAMENTO CA
95816-5015
US

IV. Provider business mailing address

2324 L ST STE 308
SACRAMENTO CA
95816-5015
US

V. Phone/Fax

Practice location:
  • Phone: 916-669-0612
  • Fax:
Mailing address:
  • Phone: 916-669-0612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: SETH CASTLEMAN
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 916-669-0612