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General NPI Number Information
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NPI Number | 1669155842
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Entity Type | Organization
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Legal Business Name | DENALI TICE MD INC.
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 850 IRON POINT RD
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City | FOLSOM
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State | CA
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Zip | 95630-9009
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Country | US
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Telephone | 916-400-9037
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 803
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City | FOLSOM
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State | CA
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Zip | 95763-0803
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Country | US
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Telephone | 916-400-9037
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Fax | 608-888-1793
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Authorized Official
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Title or Position | PRESIDENT
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Name | DENALI TICE
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Credential | MD
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Telephone | 916-400-9037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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