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General NPI Number Information
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NPI Number | 1093410128
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Entity Type | Organization
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Legal Business Name | AREA 4 AGENCY ON AGING
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Dates
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Enumeration Date | 03/30/2023
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Last Update Date | 03/30/2023
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Provider Practice Location Address
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Address Line | 1401 EL CAMINO AVENUE SUITE 400
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City | SACRAMENTO
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State | CA
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Zip | 95815-2751
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Country | US
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Telephone | 916-486-1876
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 EL CAMINO AVENUE SUITE 400
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City | SACRAMENTO
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State | CA
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Zip | 95815-2751
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Country | US
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Telephone | 916-486-1876
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | PAM S. MILLER
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Credential |
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Telephone | 916-710-8390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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