1356901490 NPI number — SACRAMENTO COUNTY OFFICE OF EDUCATION

Table of content: SAMANTHA LYNN SARACENO LCSW (NPI 1851834550)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356901490 NPI number — SACRAMENTO COUNTY OFFICE OF EDUCATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SACRAMENTO COUNTY OFFICE OF EDUCATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356901490
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/20/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 269003
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95826-9003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-228-2202
Provider Business Mailing Address Fax Number:
916-228-2216

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10474 MATHER BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MATHER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95655
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-228-2202
Provider Business Practice Location Address Fax Number:
916-228-2216
Provider Enumeration Date:
06/20/2019

Additional Information

Authorized Official

Authorized Official Last Name:
HEROTA
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSISTANT SUPERINTENDENT
Authorized Official Telephone Number:
916-228-2672

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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