Healthcare Provider Details

I. General information

NPI: 1326147919
Provider Name (Legal Business Name): SACRAMENTO COUNTY DHHS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7171 BOWLING DR SUITE 300
SACRAMENTO CA
95823-2034
US

IV. Provider business mailing address

8149 APPLE BROOK WAY AS ABOVE
ELK GROVE CA
95624-4110
US

V. Phone/Fax

Practice location:
  • Phone: 916-875-0802
  • Fax: 916-875-0854
Mailing address:
  • Phone: 916-753-5647
  • Fax: 916-875-0854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberVN196077
License Number StateCA

VIII. Authorized Official

Name: MRS. NIRUPA PRASAD
Title or Position: LVN
Credential:
Phone: 916-875-0802