Organization
DEPT OF HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISHNA RODRIGUEZ (PROGRAM TECHNICIAN)
(919) 449-5996
Entity
Organization
Contact information
Practice address
1500 CAPITOL AVE MS4719, SACRAMENTO, CA 95814
(916) 449-5996
Mailing address
P.O. BOX 997422, SACRAMENTO, CA 95899-7422
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
04/25/2007
Last updated
08/08/2008
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