1700020500 NPI number — SUTTER HEALTH SACRAMENTO SIERRA REGION

Table of content: (NPI 1700020500)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700020500 NPI number — SUTTER HEALTH SACRAMENTO SIERRA REGION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUTTER HEALTH SACRAMENTO SIERRA REGION
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:
6
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:
1700020500
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 160100
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:
95816-0100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-978-8873
Provider Business Mailing Address Fax Number:
916-978-8870

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24685 HIGHWAY 88
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PIONEER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95666
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-295-5544
Provider Business Practice Location Address Fax Number:
209-295-5233
Provider Enumeration Date:
04/23/2009

Additional Information

Authorized Official

Authorized Official Last Name:
KREVANS
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
916-286-6732

Provider Taxonomy Codes

  • Taxonomy code: 282NR1301X , with the licence number:  030000008 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: RHM53804G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com