Provider Demographics
NPI:1619271129
Name:COUNTY OF SACRAMENTO
Entity Type:Organization
Organization Name:COUNTY OF SACRAMENTO
Other - Org Name:MERCY LOAVES AND FISHES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPUTY DIRECTOR PRIMARY HEALTH
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMIANO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:916-876-7179
Mailing Address - Street 1:7001-A EAST PARKWAY SUITE 500
Mailing Address - Street 2:
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:916-391-0762
Practice Address - Street 1:1321 NORTH C STREET
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811
Practice Address - Country:US
Practice Address - Phone:916-875-9976
Practice Address - Fax:916-391-0762
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SACRAMENTO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-28
Last Update Date:2019-06-21
Deactivation Date:2016-05-05
Deactivation Code:
Reactivation Date:2019-06-21
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health