MEDICARE: SUTTER VISITING NURSE ASSOCIATION AND HOSPICE

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	251E00000X	Home Health Agency		CA

General Provider Information

NPI Number	:	1407885288
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUTTER VISITING NURSE ASSOCIATION AND HOSPICE

Provider Business Mailing Address
First Line	:	1651 ALVARADO ST
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94577-2636
Country	:	US
Telephone Number	:	510-618-5277
Fax Number	:	510-347-6866

Provider Business Practice Location Address
First Line	:	1651 ALVARADO ST
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94577-2636
Country	:	US
Telephone Number	:	510-618-5277
Fax Number	:	510-347-6866

Authorized Official
Title or Position	:	CFO
Name	:	MR. LINTON WHITE, JR.
Credential	:
Telephone Number	:	510-450-8521

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	08/11/2008

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