Organization
WELLSPACE HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALASDAIR JONATHAN PORTEUS PHD (CEO)
(916) 737-5555
Entity
Organization
Contact information
Practice address
1820 J ST, SACRAMENTO, CA 95811-3010
(916) 737-5555
(916) 444-5620
Mailing address
1820 J ST, SACRAMENTO, CA 95811-3010
(916) 550-5481
(916) 822-8974
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
261Q00000X
Clinic/Center
030000139
CA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
332U00000X
Home Delivered Meals
—
—
3747P1801X
Personal Care Attendant
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EAP11729F
PROVIDER NUMBER
CA
01
—
ZZR11729F
PROVIDER NUMBER
CA
Enumeration date
10/03/2006
Last updated
03/23/2022
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