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3749 Sudbury Rd Cameron Park CA 95682-8613 | |
| (916) 304-2098 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 3749 Sudbury Rd, Cameron Park, California |
| Authorized Official Name and Position | John Dolores (CO-OWNER) |
| Authorized Official Contact | 9163854849 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6905 Via Locanda Ave Las Vegas NV 89131-0113 Ph: (916) 385-4849 | 3749 Sudbury Rd Cameron Park CA 95682-8613 Ph: (916) 304-2098 |
| NPI Number | 1508683533 |
|---|---|
| Provider Enumeration Date | 09/23/2024 |
| Last Update Date | 12/23/2024 |
| Certification Date | 12/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508683533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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