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General NPI Number Information
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NPI Number | 1265616544
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Entity Type | Organization
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Legal Business Name | HEALING PATHWAYS MEDICAL CLINIC, INC.
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Dates
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Enumeration Date | 12/22/2007
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 3451 BURROWS AVENUE
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691
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Country | US
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Telephone | 916-376-8416
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Fax | 916-376-0759
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Provider Business Mailing Address
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Address Line | PO BOX 981612
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City | WEST SACRAMENTO
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State | CA
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Zip | 95798
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Country | US
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Telephone | 916-376-8416
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Fax | 916-376-0759
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Authorized Official
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Title or Position | CEO/OWNER
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Name | DR. PAUL CLIFFORD COPELAND
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Credential | DO
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Telephone | 916-376-8416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 20A5642
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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