Healthcare Provider Details

I. General information

NPI: 1366853947
Provider Name (Legal Business Name): HRC TCORE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 05/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 MARCONI AVE
SACRAMENTO CA
95821-5303
US

IV. Provider business mailing address

3737 MARCONI AVE
SACRAMENTO CA
95821-5303
US

V. Phone/Fax

Practice location:
  • Phone: 916-480-1801
  • Fax: 916-854-1809
Mailing address:
  • Phone: 916-480-1801
  • Fax: 916-854-1809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MARLYN SEPULVEDA
Title or Position: PROGRAM DIRECTOR
Credential: ASW
Phone: 916-480-1801