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Organization

EDC MH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VIBHA K UDUPA (MSW II INTERN)
(916) 564-0503
Entity
Organization

Contact information

Practice address
126 REDWOOD AVE, SACRAMENTO, CA 95815-2010
(916) 564-0503
Mailing address
126 REDWOOD AVE, SACRAMENTO, CA 95815-2010
(916) 564-0503

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
3714

Other

Enumeration date
04/10/2007
Last updated
08/22/2020
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