Organization
WESTERN SIERRA PSYCHIATRIC GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE WENOKUR (PSYCHIATRIST)
(916) 451-5294
Entity
Organization
Contact information
Practice address
1409 28TH ST, #200, SACRAMENTO, CA 95816-6422
(916) 451-5294
Mailing address
1409 28TH ST, #200, SACRAMENTO, CA 95816-6422
(916) 451-5294
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
20A5621
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY NUMBER
CA
Enumeration date
12/28/2006
Last updated
08/22/2020
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