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1255667234 NPI number — SIERRA STONEGATE

NPI Number: 1255667234
Health Care Provider/Practitioner: SIERRA STONEGATE

Information about “1255667234” NPI (SIERRA STONEGATE) exists in 1255667234 in HTML format HTML  |  1255667234 in plain Text format TXT  |  1255667234 in PDF (Portable Document Format) PDF  |  1255667234 in an XML format XML  formats.

NPI Number : 1255667234 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1255667234",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SIERRA STONEGATE",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4140 BUCHANAN DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FAIR OAKS",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95628-6104",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "530-354-0304",
    "MailingAddressFaxNumber": "916-941-7498",
    "FirstLinePracticeLocationAddress": "4140 BUCHANAN DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FAIR OAKS",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "95628-6104",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "530-354-0304",
    "PracticeLocationAddressFaxNumber": "916-941-7498",
    "EnumerationDate": "10/26/2009",
    "LastUpdateDate": "03/26/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HILL",
    "AuthorizedOfficialFirstName": "ANTHONY",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "ADMIN.",
    "AuthorizedOfficialTelephoneNumber": "530-354-0304",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "320800000X",
          "TaxonomyName": "Mental Illness Community Based Residential Treatment Facility",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "324500000X",
          "TaxonomyName": "Substance Abuse Rehabilitation Facility",
          "LicenseNumber": "340099AP",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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