Healthcare Provider Details

I. General information

NPI: 1578639308
Provider Name (Legal Business Name): REGENTS OF THE UNIVERSITY OF CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3575 BUSINESS DRIVE SUITE 1702
SACRAMENTO CA
95820
US

IV. Provider business mailing address

2315 STOCKTON BLVD ATTN: PHARMACY ADMINISTRATION
SACRAMENTO CA
95817-2201
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-0900
  • Fax: 916-703-5194
Mailing address:
  • Phone: 916-734-3305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHE37805
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

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