| NPI | 1366091894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATE INGERSOLL Executive Director, Fiscal Services 916-566-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251X00000X Supports Brokerage |
| Enumeration Date | 2019-09-07 |
| Last Update Date | 2019-09-07 |