Provider Demographics
NPI:1013110949
Name:RIVER OAK CENTER FOR CHILDREN
Entity type:Organization
Organization Name:RIVER OAK CENTER FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM SERVICES CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SHAUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-284-3467
Mailing Address - Street 1:7484 HOLWORTHY WAY APT 115
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95842-4133
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5030 EL CAMINO AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-4650
Practice Address - Country:US
Practice Address - Phone:916-609-5122
Practice Address - Fax:916-609-5161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health