Organization
WELLBOUND OF EMERYVILLE LLC
Active
Other names
Satellite WellBound of Sacramento University
Organization subpart
No
Provider details
NPI number
Authorized official
BERNADETTE VINCENT (PRESIDENT/COO)
(650) 404-3600
Entity
Organization
Contact information
Practice address
3 PARK CENTER DR STE 120, SACRAMENTO, CA 95825
(916) 486-8005
(916) 486-9585
Mailing address
300 SANTANA ROW STE 300, SAN JOSE, CA 95128-2424
(650) 404-3655
(650) 625-6007
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3130448
DBA
CA
Enumeration date
05/04/2018
Last updated
01/14/2023
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