MEDICARE: SIERRA SUNRISE SENIOR VILLAGE

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	314000000X	Skilled Nursing Facility		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700859477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIERRA SUNRISE SENIOR VILLAGE

Provider Business Mailing Address
First Line	:	2850 SIERRA SUNRISE TER
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-8401
Country	:	US
Telephone Number	:	530-894-1010
Fax Number	:	530-894-0147

Provider Business Practice Location Address
First Line	:	2850 SIERRA SUNRISE TER
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-8401
Country	:	US
Telephone Number	:	530-894-1010
Fax Number	:	530-894-0147

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. BECKY A BOWEN
Credential	:
Telephone Number	:	530-894-1010

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	08/22/2020

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