Healthcare Provider Details

I. General information

NPI: 1124246947
Provider Name (Legal Business Name): COMMUNICARE HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 JEFFERSON BLVD STE B180
WEST SACRAMENTO CA
95605-2394
US

IV. Provider business mailing address

PO BOX 1260
DAVIS CA
95617-1260
US

V. Phone/Fax

Practice location:
  • Phone: 916-403-2900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateCA

VIII. Authorized Official

Name: KRISTIE STANLEY
Title or Position: DIRECTOR OF CLINICAL INFO SYSTEMS
Credential:
Phone: 530-753-3498