Provider Demographics
NPI:1912069568
Name:SIERRA MANAGEMENT SERVICES INC.
Entity Type:Organization
Organization Name:SIERRA MANAGEMENT SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SIRI PRITAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-671-7770
Mailing Address - Street 1:1110 CIVIC CENTER BLVD
Mailing Address - Street 2:# 502
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-3013
Mailing Address - Country:US
Mailing Address - Phone:530-671-7977
Mailing Address - Fax:530-671-6163
Practice Address - Street 1:1110 CIVIC CENTER BLVD
Practice Address - Street 2:# 502
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-3013
Practice Address - Country:US
Practice Address - Phone:530-671-7977
Practice Address - Fax:530-671-6163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ621752OtherBLUE SHIELD NUMBER
CAZZZ21206ZMedicare ID - Type UnspecifiedGROUPNUMBER