Provider Demographics
NPI:1659036754
Name:DELICANA, RICHMON REYES
Entity Type:Individual
Prefix:
First Name:RICHMON
Middle Name:REYES
Last Name:DELICANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SACRAMENTO COUNTY MENTAL HEALTH TREATMENT CENTER
Mailing Address - Street 2:2150 STOCKTON BLVD.
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817
Mailing Address - Country:US
Mailing Address - Phone:916-875-1000
Mailing Address - Fax:
Practice Address - Street 1:SACRAMENTO COUNTY MENTAL HEALTH TREATMENT CENTER
Practice Address - Street 2:2150 STOCKTON BLVD.
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-875-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95193643163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse