Provider Demographics
NPI:1619194594
Name:COUNTY OF SUTTER
Entity Type:Organization
Organization Name:COUNTY OF SUTTER
Other - Org Name:CHDP
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF HUMAN SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:O'HARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-822-7327
Mailing Address - Street 1:1445 VETERANS MEMORIAL CIR
Mailing Address - Street 2:ATTN HEALTH DIVISION (CHDP)
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-3011
Mailing Address - Country:US
Mailing Address - Phone:530-822-7215
Mailing Address - Fax:530-822-7223
Practice Address - Street 1:1445 VETERANS MEMORIAL CIR
Practice Address - Street 2:ATTN HEALTH DIVISION (CHDP)
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-3011
Practice Address - Country:US
Practice Address - Phone:530-822-7215
Practice Address - Fax:530-822-7223
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SUTTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-20
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEXE70043FMedicaid