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NPI Code Detail

MEDICARE: SUTTER VALLEY MEDICAL FOUNDATION

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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1417810003
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 :
Fax Number :
Provider Business Practice Location Address
First Line : 2488 N CALIFORNIA ST
Second Line :
City : STOCKTON
State : CA
Zip : 95204-5508
Country : US
Telephone Number : 209-948-3333
Fax Number :
Authorized Official
Title or Position : SR. DIRECTOR, PLANNING AND ALIGNMEN
Name : KRISTIN KELLER
Credential :
Telephone Number : 800-478-8837
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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Directions to “SUTTER VALLEY MEDICAL FOUNDATION ” Practice Location

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