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2700 Fulton Ave Sacramento CA 95821-5102 | |
| (916) 874-3800 | |
| (916) 874-1241 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 2700 Fulton Ave, Sacramento, California |
| Authorized Official Name and Position | Uma Zykofsky (DEPUTY DIRECTOR) |
| Authorized Official Contact | 9168759904 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7001a East Pkwy Suite 400 Sacramento CA 95823-2501 Ph: (916) 875-4948 | 2700 Fulton Ave Sacramento CA 95821-5102 Ph: (916) 874-3800 |
| NPI Number | 1033285655 |
|---|---|
| Provider Enumeration Date | 11/27/2006 |
| Last Update Date | 09/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033285655 | NPI | - | NPPES |
| 8481 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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