Healthcare Provider Details

I. General information

NPI: 1245774785
Provider Name (Legal Business Name): MR. RYAN MICHAEL SAENZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2016
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 BEACON BLVD STE 103
WEST SACRAMENTO CA
95691-3467
US

IV. Provider business mailing address

3050 BEACON BLVD STE 103
WEST SACRAMENTO CA
95691-3467
US

V. Phone/Fax

Practice location:
  • Phone: 916-462-3100
  • Fax:
Mailing address:
  • Phone: 916-462-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number103169
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number140773
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: