Provider Demographics
NPI:1326062613
Name:SUTTER CENTRAL VALLEY HOSPITALS
Entity Type:Organization
Organization Name:SUTTER CENTRAL VALLEY HOSPITALS
Other - Org Name:VISITING NURSE ASSOCIATION OF THE CENTRAL VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:209-342-4000
Mailing Address - Street 1:1316 CELESTE AVE.
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355
Mailing Address - Country:US
Mailing Address - Phone:209-526-4500
Mailing Address - Fax:209-342-4039
Practice Address - Street 1:1316 CELESTE AVE.
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355
Practice Address - Country:US
Practice Address - Phone:209-571-1055
Practice Address - Fax:209-342-4039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA057695251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA057695Medicare Oscar/Certification