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General NPI Number Information
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NPI Number | 1730989286
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Entity Type | Organization
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Legal Business Name | EL DORADO COUNTY PROBATION DEPARTMENT
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Dates
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Enumeration Date | 03/14/2025
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 1041 AL TAHOE BLVD.
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-4502
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Country | US
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Telephone | 530-621-7990
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Fax |
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Provider Business Mailing Address
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Address Line | 3974 DUROCK ROAD, SUITE 205
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City | SHINGLE SPRINGS
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State | CA
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Zip | 95682
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Country | US
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Telephone | 530-621-5625
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Fax |
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Authorized Official
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Title or Position | CHIEF PROBATION OFFICER
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Name | BRIAN RICHART
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Credential |
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Telephone | 530-621-5625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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