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General NPI Number Information
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NPI Number | 1669846986
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Entity Type | Organization
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Legal Business Name | SUTTER VALLEY MEDICAL FOUNDATION
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Dates
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Enumeration Date | 11/24/2015
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 600 COFFEE RD
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City | MODESTO
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State | CA
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Zip | 95355-4201
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Country | US
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Telephone | 209-524-1211
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 255228
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City | SACRAMENTO
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State | CA
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Zip | 95865-5228
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SH VP, QUALITY, SAFETY AND PATIENT
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Name | KRISTA LOPES
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Credential |
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Telephone | 916-384-7544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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