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General NPI Number Information
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NPI Number | 1487192571
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Entity Type | Organization
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Legal Business Name | SIERRA PREGNANCY & HEALTH
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Dates
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Enumeration Date | 02/08/2017
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Last Update Date | 02/08/2017
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Provider Practice Location Address
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Address Line | 1212 COLOMA WAY STE. A
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City | ROSEVILLE
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State | CA
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Zip | 95661-4646
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Country | US
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Telephone | 916-624-8990
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Fax | 916-624-8990
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Provider Business Mailing Address
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Address Line | 1212 COLOMA WAY STE. A
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City | ROSEVILLE
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State | CA
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Zip | 95661-4646
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Country | US
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Telephone | 916-624-8990
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Fax | 916-624-8990
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Authorized Official
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Title or Position | NURSE MANAGER
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Name | MOLLY MIKAELA BATTENFIELD
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Credential | RN
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Telephone | 916-624-8990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | CA630016612
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License Number State | CA
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