Provider Demographics
NPI:1346519139
Name:CENTER FOR COMMUNITY HEALTH AND WELL-BEING, INC
Entity Type:Organization
Organization Name:CENTER FOR COMMUNITY HEALTH AND WELL-BEING, INC
Other - Org Name:NEW BEGINNINGS BIRTH AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PETKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-558-4800
Mailing Address - Street 1:1900 T STREET
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-6822
Mailing Address - Country:US
Mailing Address - Phone:916-897-9900
Mailing Address - Fax:916-667-8791
Practice Address - Street 1:7600 HOSPITAL DRIVE
Practice Address - Street 2:SUITE I
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5406
Practice Address - Country:US
Practice Address - Phone:916-897-9900
Practice Address - Fax:916-667-8791
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER FOR COMMUNITY HEALTH AND WELL-BEING, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-22
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207X00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty