MEDICARE: COUNTY OF SACRAMENTO

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	:	1922841568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF SACRAMENTO

Provider Business Mailing Address
First Line	:	7001A EAST PKWY STE 100
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-2501
Country	:	US
Telephone Number	:	916-875-0847
Fax Number	:

Provider Business Practice Location Address
First Line	:	711 G ST STE 100
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95814-1212
Country	:	US
Telephone Number	:	916-875-1905
Fax Number	:

Authorized Official
Title or Position	:	BEHAVIORAL HEALTH DIRECTOR
Name	:	RYAN QUIST
Credential	:	PH.D.
Telephone Number	:	916-875-9904

Provider Enumeration Date	:	06/13/2024
Last Update Date	:	10/15/2024

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Directions to “COUNTY OF SACRAMENTO ” Practice Location

Language	Start Address	Practice Location

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