| NPI | 1538300686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY CLOTHIER Credentialing Manager 916-228-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA 302F00000X) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2009-03-19 |
| Last Update Date | 2024-02-21 |