Organization
WELLSPACE NEXUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN PORTEUS PHD (CEO)
(916) 737-5577
Entity
Organization
Contact information
Practice address
777 12TH ST STE 250, SACRAMENTO, CA 95814-1929
(916) 737-5555
Mailing address
777 12TH ST STE 250, SACRAMENTO, CA 95814-1929
(916) 737-5577
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
05/13/2022
Last updated
06/07/2022
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