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General NPI Number Information
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NPI Number | 1114869013
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Entity Type | Organization
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Legal Business Name | CHAPA-DE INDIAN HEALTH PROGRAM INC
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Dates
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Enumeration Date | 04/08/2026
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Last Update Date | 04/08/2026
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Provider Practice Location Address
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Address Line | 1451 W STANFORD RANCH RD
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City | ROCKLIN
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State | CA
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Zip | 95765-4993
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Country | US
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Telephone | 530-887-2800
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Fax | 530-887-2819
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Provider Business Mailing Address
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Address Line | 11670 ATWOOD RD
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City | AUBURN
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State | CA
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Zip | 95603-9522
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Country | US
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Telephone | 530-887-2841
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Fax | 530-887-7408
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. SIERK HAITSMA
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Credential |
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Telephone | 530-887-2841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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