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Organization

PLACER COE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHANIE CHIQUILLO KAISER (MENTAL HEALTH COORDINATOR)
(916) 572-6671
Entity
Organization

Contact information

Practice address
1400 W STANFORD RANCH RD, ROCKLIN, CA 95765-3811
(916) 630-0550
Mailing address
1400 W STANFORD RANCH RD, ROCKLIN, CA 95765-3811
(916) 630-0550

Taxonomy

Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31-10314
MEDI-CAL
CA
Enumeration date
01/03/2007
Last updated
10/21/2025
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