WELLSPACE HEALTH NPI 1740587914

NPI Information

NPI: 1740587914
Provider Name: WELLSPACE HEALTH
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 05D2181021

Address:
3900 47TH AVE
SACRAMENTO, CA
ZIP 95824
Phone: (916) 313-8488
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WELLSPACE HEALTH is a health service clinic center in Sacramento, CA. WELLSPACE HEALTH NPI is 1740587914. The provider is registered as an organization entity type.

The provider's business location address is:

3900 47TH AVE
SACRAMENTO, CA
ZIP 95824-430
Phone: (916) 313-8488
Fax: (916) 313-8495

The provider's authorized official is Alasdair 'jonathan' Porteus .
The authorized official title is Chief Executive Officer and has the following contact phone number (916) 737-5555.

The CLIA number assigned to this NPI record is 05D2181021 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/23/2011 and was last updated on 7/20/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	551095	MEDICARE OSCAR/CERTIFICATION	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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