WELLSPACE HEALTH NPI 1265777692

NPI Information

NPI: 1265777692
Provider Name: WELLSPACE HEALTH
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 05D2060646

Address:
631 H ST
SACRAMENTO, CA
ZIP 95814
Phone: (916) 569-8650
Get Directions

WELLSPACE HEALTH is a federally qualified health center (fqhc) clinic center in Sacramento, CA. WELLSPACE HEALTH NPI is 1265777692. The provider is registered as an organization entity type.

The provider's business location address is:

631 H ST
SACRAMENTO, CA
ZIP 95814
Phone: (916) 569-8650
Fax: (916) 554-5482

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 05D2060646 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/12/2012 and was last updated on 3/23/2022.

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	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	No
2	332U00000X	Home Delivered Meals		No
3	3747P1801X	Technician	Personal Care Attendant	No
4	385H00000X	Respite Care		No
5	171M00000X	Case Manager/Care Coordinator		No
6	171W00000X	Contractor		No
7	251C00000X	Day Training, Developmentally Disabled Services		No
8	251X00000X	Supports Brokerage		No
9	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	Yes

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: 4/28/2024

NPI Synchronization or Removal

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