| Samuel Jackman Middle School | |
|
7925 Kentwall Dr Sacramento CA 95823-6637 | |
| (916) 393-2352 | |
| Not Available |
| Full Name | Samuel Jackman Middle School |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7925 Kentwall Dr, Sacramento, California |
| Authorized Official Name and Position | Star Cannon (PROGRAMS MANAGER/DIRECTOR) |
| Authorized Official Contact | 9163889418 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel Jackman Middle School 5415 Florin Rd Sacramento CA 95823-2105 Ph: (916) 361-2089 | Samuel Jackman Middle School 7925 Kentwall Dr Sacramento CA 95823-6637 Ph: (916) 393-2352 |
| NPI Number | 1114105962 |
|---|---|
| Provider Enumeration Date | 02/04/2008 |
| Last Update Date | 01/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114105962 | NPI | - | NPPES |
| 3434 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 3432 (California) | Primary |
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