Organization
MARSHALL MEDICAL CENTER
Active
Other names
Marshall Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
KIM SANGUINETTI-WEISHAAR (PROVIDER CREDENTIALING)
(530) 626-2770
Entity
Organization
Contact information
Practice address
3581 PALMER DR STE 202, CAMERON PARK, CA 95682-8237
(530) 672-7000
Mailing address
PO BOX 45680, SAN FRANCISCO, CA 94145-0680
(530) 626-2618
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ00439Z
—
CA
Enumeration date
04/15/2019
Last updated
04/15/2019
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