| NPI | 1841713732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARINA VANESSA MARTIN Facility Licensing Specialist 916-469-4690 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2025-09-24 |