Provider Demographics
NPI:1619394897
Name:GENDER HEALTH CENTER
Entity Type:Organization
Organization Name:GENDER HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-520-3554
Mailing Address - Street 1:2020 29TH ST
Mailing Address - Street 2:STE 201
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1119
Mailing Address - Country:US
Mailing Address - Phone:916-455-2391
Mailing Address - Fax:916-455-2393
Practice Address - Street 1:2020 29TH ST
Practice Address - Street 2:STE 201
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1119
Practice Address - Country:US
Practice Address - Phone:916-455-2391
Practice Address - Fax:916-455-2393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 14463251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health