Provider Demographics
NPI:1790720993
Name:SUTTER HEALTH SACRAMENTO SIERRA REGION
Entity Type:Organization
Organization Name:SUTTER HEALTH SACRAMENTO SIERRA REGION
Other - Org Name:SUTTER AUBURN FAITH HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CONFORTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-887-7040
Mailing Address - Street 1:PO BOX 619092
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-9092
Mailing Address - Country:US
Mailing Address - Phone:915-297-8079
Mailing Address - Fax:
Practice Address - Street 1:11815 EDUCATION ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95602-2410
Practice Address - Country:US
Practice Address - Phone:530-888-4557
Practice Address - Fax:530-888-6611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA05D0644110291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1790720993OtherMEDI-CAL
CA1790720993OtherMEDI-CAL