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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1629702030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIGNITY HEALTH

Provider Business Mailing Address
First Line	:	1400 E CHURCH ST
Second Line	:	ADMINISTRATION
City	:	SANTA MARIA
State	:	CA
Zip	:	93454-5906
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 E MAIN ST
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93454-4801
Country	:	US
Telephone Number	:	805-614-5620
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MATTHEW RICHARDSON
Credential	:
Telephone Number	:	805-739-3100

Provider Enumeration Date	:	07/12/2022
Last Update Date	:	07/12/2022

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Directions to “DIGNITY HEALTH ” Practice Location

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