NPI Code Details Logo

NPI 1972637908

NPI 1972637908 : DIGNITY HEALTH MEDICAL FOUNDATION : SACRAMENTO, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1972637908
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    DIGNITY HEALTH MEDICAL FOUNDATION 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/14/2007
-----------------------------------------------------
    Last Update Date     |    11/18/2020
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    6615 VALLEY HI DR SUITE A
-----------------------------------------------------
    City                 |    SACRAMENTO
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    95823-7076
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    916-681-6300
-----------------------------------------------------
    Fax                  |    916-681-6354
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    3000 Q ST 
-----------------------------------------------------
    City                 |    SACRAMENTO
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    95816-7058
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CHIEF FINANCIAL OFFICER
-----------------------------------------------------
    Name                 |     THERESA M HYLEN 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    916-851-2559
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QM0855X
-----------------------------------------------------
    Taxonomy Name        |    Adolescent and Children Mental Health Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.