Provider Demographics
NPI:1619731809
Name:MATTHEWS, CAROLINE
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 HOWE AVE BLDG. 300, SACRAMENTO, CA 95825
Mailing Address - Street 2:948 SACRAMENTO AVE, WEST SACRAMENTO, CA 95605
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825
Mailing Address - Country:US
Mailing Address - Phone:916-695-4945
Mailing Address - Fax:
Practice Address - Street 1:650 HOWE AVE BLDG. 300, SACRAMENTO, CA 95825
Practice Address - Street 2:948 SACRAMENTO AVE, WEST SACRAMENTO, CA 95605
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825
Practice Address - Country:US
Practice Address - Phone:916-695-4945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator