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General NPI Number Information
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NPI Number | 1982073474
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Entity Type | Organization
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Legal Business Name | KAISER PERMANENTE
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 09/15/2015
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Provider Practice Location Address
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Address Line | 6600 BRUCEVILLE RD
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City | SACRAMENTO
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State | CA
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Zip | 95823-4671
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Country | US
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Telephone | 916-688-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 621 4TH ST
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City | DAVIS
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State | CA
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Zip | 95616-4151
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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 | BEHAVIORAL MEDICINE SPECIALIST PSYC
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Name | DANEN ADELSON
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Credential | PSY.D.
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Telephone | 530-988-8535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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