Organization
WELLBOUND OF EMERYVILLE LLC
Active
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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