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650 Howe Ave Bldg 400-b Sacramento CA 95825-4731 | |
| (916) 441-0123 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 650 Howe Ave Bldg 400-b, Sacramento, California |
| Authorized Official Name and Position | Erin K Johansen (CEO) |
| Authorized Official Contact | 9164410123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
650 Howe Ave Bldg 400-a Sacramento CA 95825-4731 Ph: (916) 441-0123 | 650 Howe Ave Bldg 400-b Sacramento CA 95825-4731 Ph: (916) 441-0123 |
| NPI Number | 1861566820 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 02/16/2022 |
| Certification Date | 02/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861566820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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