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General NPI Number Information
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NPI Number | 1326053265
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Entity Type | Organization
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Legal Business Name | SACRAMENTO JAIL
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 651 I ST
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City | SACRAMENTO
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State | CA
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Zip | 95814-2400
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Country | US
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Telephone | 916-874-5222
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Fax | 916-874-6904
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Provider Business Mailing Address
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Address Line | 651 I ST.
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City | SACRAMENTO
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State | CA
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Zip | 95814
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Country | US
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Telephone | 916-874-5222
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Fax | 916-874-6904
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MR. MICHAEL B SINGER
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Credential | LCSW
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Telephone | 916-874-5222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2400X
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Taxonomy Name | Prison Health Clinic/Center
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License Number | LI 10571
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License Number State | CA
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