Healthcare Provider Details

I. General information

NPI: 1073450243
Provider Name (Legal Business Name): CITY OF SACRAMENTO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 I ST STE 120
SACRAMENTO CA
95814-2819
US

IV. Provider business mailing address

1000 I ST STE 120
SACRAMENTO CA
95814-2819
US

V. Phone/Fax

Practice location:
  • Phone: 916-808-7923
  • Fax:
Mailing address:
  • Phone: 916-808-7923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. TIM SWANSON
Title or Position: ASSISTANT DIRECTOR, DCR
Credential:
Phone: 916-808-7923