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17340 Yolo Ave Esparto CA 95627-2265 | |
(530) 787-4110 | |
(530) 787-4104 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 17340 Yolo Ave, Esparto, California |
Authorized Official Name and Position | Laura Guevara (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2096063229 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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17340 Yolo Ave. Esparto CA 95627-2137 Ph: (530) 787-4110 | 17340 Yolo Ave Esparto CA 95627-2265 Ph: (530) 787-4110 |
NPI Number | 1558855338 |
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Provider Enumeration Date | 06/15/2018 |
Last Update Date | 08/02/2024 |
Certification Date | 08/02/2024 |
Identifier | Type | State | Issuer |
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1558855338 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |