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General NPI Number Information
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NPI Number | 1609202183
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Entity Type | Organization
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Legal Business Name | SACRAMENTO COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES CHEST CLINIC
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Dates
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Enumeration Date | 09/17/2013
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 4600 BROADWAY STE 1300
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City | SACRAMENTO
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State | CA
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Zip | 95820-1527
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Country | US
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Telephone | 916-874-9823
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Fax |
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Provider Business Mailing Address
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Address Line | 7001 EAST PKWY STE 250A
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City | SACRAMENTO
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State | CA
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Zip | 95823-2501
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Country | US
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Telephone | 916-876-8852
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Fax | 191-639-1076
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Authorized Official
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Title or Position | PHN
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Name | MS. SHARYL KAYE STURDEVANT
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Credential | RN,BSN
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Telephone | 916-874-9823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 571220
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 571220
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 571220
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License Number State | CA
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