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1487694857

NPI Code Detail

MEDICARE: DIGNITY HEALTH

MEDICARE: DIGNITY HEALTH

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	273Y00000X	Rehabilitation Hospital Unit	030000062	CA
2	314000000X	Skilled Nursing Facility	030000062	CA
3	282N00000X	General Acute Care Hospital	030000062	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	196456502	OTHER	CA	DEPT. OF LABOR - WC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	942761692958190000	OTHER		WPS TRICARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	ZZZA3401Z	OTHER		BLUE SHIELD OF CA
9	942761692	OTHER		IRS - PRE-MERGER TAX ID
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487694857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIGNITY HEALTH

Provider Business Mailing Address
First Line	:	3215 PROSPECT PARK DR
Second Line	:
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95670-6017
Country	:	US
Telephone Number	:	858-275-8112
Fax Number	:	779-803-8118

Provider Business Practice Location Address
First Line	:	4001 J ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-3626
Country	:	US
Telephone Number	:	858-275-8112
Fax Number	:	779-803-8118

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	DANIEL MORISSETTE
Credential	:
Telephone Number	:	858-275-8112

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	06/18/2025

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Directions to “DIGNITY HEALTH ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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