Organization
DEPARTMENT OF STATE HOSPITALS
Active
Parent organization
DEPARTMENT OF STATE HOSPITALS
Other names
Department of State Hospitals - Patton
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEPARTMENT OF STATE HOSPITALS
Authorized official
GUADALUPE M ALONZO-DIAZ (ADMINISTRATIVE DEPUTY DIRECTOR)
(916) 654-2655
Entity
Organization
Contact information
Practice address
3102 E HIGHLAND AVE, PATTON, CA 92369-7813
(909) 425-7552
(909) 425-6407
Mailing address
1215 O STREET, MS-3, PATIENT COST RECOVERY SECTION, SACRAMENTO, CA 95814-6414
(916) 651-8811
(916) 651-8908
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
170000831
CA
282N00000X
General Acute Care Hospital
170000831
CA
283Q00000X
Psychiatric Hospital
Primary
170000831
CA
310500000X
Mental Illness Intermediate Care Facility
170000831
CA
333600000X
Pharmacy
170000831
CA
3336L0003X
Long Term Care Pharmacy
170000831
CA
Other
Enumeration date
07/01/2006
Last updated
06/28/2021
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