| NPI | 1346294907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKKI BUCKSTEAD PANE Executive Director 916-922-9217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA 19608) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-08-22 |