MEDICARE: CAPITAL COLLEGE & CAREER ACADEMY

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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1962365643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPITAL COLLEGE & CAREER ACADEMY

Provider Business Mailing Address
First Line	:	501 ARDEN WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95815-3004
Country	:	US
Telephone Number	:	916-234-0583
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 ARDEN WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95815-3004
Country	:	US
Telephone Number	:	916-234-0583
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	KEVIN DOBSON
Credential	:
Telephone Number	:	916-234-0583

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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