Provider Demographics
NPI:1770016172
Name:TRINA HEALTH OF NORTHERN CALIFORNIA PC
Entity Type:Organization
Organization Name:TRINA HEALTH OF NORTHERN CALIFORNIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:DE BONILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-226-3736
Mailing Address - Street 1:4441 AUBURN BLVD
Mailing Address - Street 2:SUITE J
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-4139
Mailing Address - Country:US
Mailing Address - Phone:916-226-3736
Mailing Address - Fax:
Practice Address - Street 1:4441 AUBURN BLVD
Practice Address - Street 2:SUITE J
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-4139
Practice Address - Country:US
Practice Address - Phone:916-226-3736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty