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General NPI Number Information
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NPI Number | 1619394897
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Entity Type | Organization
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Legal Business Name | GENDER HEALTH CENTER
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Dates
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Enumeration Date | 03/25/2014
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Last Update Date | 03/25/2014
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Provider Practice Location Address
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Address Line | 2020 29TH ST STE 201
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City | SACRAMENTO
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State | CA
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Zip | 95817-1119
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Country | US
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Telephone | 916-455-2391
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Fax | 916-455-2393
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Provider Business Mailing Address
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Address Line | 2020 29TH ST STE 201
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City | SACRAMENTO
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State | CA
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Zip | 95817-1119
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Country | US
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Telephone | 916-455-2391
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Fax | 916-455-2393
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BEN HUDSON
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Credential |
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Telephone | 916-520-3554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LCS 14463
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License Number State | CA
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