Healthcare Provider Details

I. General information

NPI: 1336487685
Provider Name (Legal Business Name): REGENTS OF THE UNIVERSITY OF CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2013
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4868 X ST STE 1500
SACRAMENTO CA
95817-2205
US

IV. Provider business mailing address

PO BOX 744719
LOS ANGELES CA
90074-4719
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-6250
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number43732
License Number StateCA

VIII. Authorized Official

Name: JENNIFER DOLL
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 916-734-9446