MEDICARE: SUTTER VALLEY MEDICAL FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1053891341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUTTER VALLEY MEDICAL FOUNDATION

Provider Business Mailing Address
First Line	:	PO BOX 255228
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95865-5228
Country	:	US
Telephone Number	:	866-681-0736
Fax Number	:

Provider Business Practice Location Address
First Line	:	2702 LOW CT
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94534-9771
Country	:	US
Telephone Number	:	707-432-2660
Fax Number	:	707-432-2661

Authorized Official
Title or Position	:	SR. DIRECTOR, PLANNING AND ALIGNMEN
Name	:	KRISTIN KELLER
Credential	:
Telephone Number	:	650-934-7000

Provider Enumeration Date	:	08/16/2018
Last Update Date	:	03/18/2026

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