Provider Demographics
NPI:1093036741
Name:SACRAMENTO COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES
Entity Type:Organization
Organization Name:SACRAMENTO COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT TECH
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:K
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-875-9976
Mailing Address - Street 1:7001A EAST PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2501
Mailing Address - Country:US
Mailing Address - Phone:916-875-9976
Mailing Address - Fax:916-875-9976
Practice Address - Street 1:7001 A EAST PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823
Practice Address - Country:US
Practice Address - Phone:916-875-9976
Practice Address - Fax:916-875-9976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========1Medicaid