MEDICARE: CATHOLIC SOCIAL SERVICE

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		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	261QM0850X	OTHER	CA	ADULT MENTAL HEALTH

General Provider Information

NPI Number	:	1851473599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHOLIC SOCIAL SERVICE

Provider Business Mailing Address
First Line	:	5890 NEWMAN CT STE 3
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-2608
Country	:	US
Telephone Number	:	916-452-7481
Fax Number	:	916-736-0282

Provider Business Practice Location Address
First Line	:	5890 NEWMAN CT STE 3
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-2608
Country	:	US
Telephone Number	:	916-452-7481
Fax Number	:	916-736-0282

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	ALISON ANNE BUCKLEY
Credential	:	M.A.
Telephone Number	:	916-452-7481

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	08/22/2020

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Directions to “CATHOLIC SOCIAL SERVICE ” Practice Location

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