MARSHALL MEDICAL CENTER NPI 1356904577

NPI Information

NPI: 1356904577
Provider Name: MARSHALL MEDICAL CENTER
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

CLIA Number: 05D0872563

Address:
3581 PALMER DR STE 202
CAMERON PARK, CA
ZIP 95682
Phone: (530) 672-7000
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MARSHALL MEDICAL CENTER is an adult mental health clinic center in Cameron Park, CA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. MARSHALL MEDICAL CENTER NPI is 1356904577. The provider is registered as an organization entity type.

The provider's business location address is:

3581 PALMER DR STE 202
CAMERON PARK, CA
ZIP 95682-237
Phone: (530) 672-7000

The provider's authorized official is Kim Sanguinetti-weishaar .
The authorized official title is Provider Credentialing and has the following contact phone number (530) 626-2770.

The CLIA number assigned to this NPI record is 05D0872563 - hospital with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/15/2019 and was last updated on 4/15/2019.

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	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			No
2	261QM0850X	Clinic/Center	Adult Mental Health			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	ZZZ00439Z	MEDICAID	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: 4/28/2024

NPI Synchronization or Removal

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