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General NPI Number Information
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NPI Number | 1417231408
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Entity Type | Organization
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Legal Business Name | SACRAMENTO PSYCHIATRIC ASSOCIATES
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Dates
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Enumeration Date | 10/07/2011
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | 1913 CAPITOL AVE SUITE D
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City | SACRAMENTO
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State | CA
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Zip | 95811-4226
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Country | US
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Telephone | 916-444-7054
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Fax | 916-444-3907
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Provider Business Mailing Address
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Address Line | 1913 CAPITOL AVE SUITE D
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City | SACRAMENTO
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State | CA
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Zip | 95811-4226
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Country | US
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Telephone | 916-444-7054
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Fax | 916-444-3907
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. DAVID SISEMORE
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Credential | D.O.
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Telephone | 916-444-7054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 20A9327
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License Number State | CA
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