Provider Demographics
NPI:1679504542
Name:SACRAMENTO COUNTY
Entity Type:Organization
Organization Name:SACRAMENTO COUNTY
Other - Org Name:ADULT ACCESS
Other - Org Type:Other Name
Authorized Official - Title/Position:LICENSED SR. MENTAL HEALTH COUNSELO
Authorized Official - Prefix:MISS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:916-874-5196
Mailing Address - Street 1:8853 MOHAMED CIR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-2232
Mailing Address - Country:US
Mailing Address - Phone:408-509-8480
Mailing Address - Fax:
Practice Address - Street 1:8853 MOHAMED CIR
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-2232
Practice Address - Country:US
Practice Address - Phone:408-509-8480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40210305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service