Provider Demographics
NPI:1518145002
Name:PARKS, DION FRANCIS (PA)
Entity Type:Individual
Prefix:
First Name:DION
Middle Name:FRANCIS
Last Name:PARKS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:2725 CAPITOL AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6004
Practice Address - Country:US
Practice Address - Phone:916-262-9440
Practice Address - Fax:916-262-9445
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA 15440363A00000X
CA483525163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health