SACRAMENTO CHILD AND ADOLESCENT WELLNESS CENTER CORP (NPI# 1184080681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184080681 |
| Entity Type | Organization |
| Organization Name | SACRAMENTO CHILD AND ADOLESCENT WELLNESS CENTER CORP |
| Practice Address |
2001 N St Suite 100 Sacramento CA 95811-4237 |
| Mailing Address |
2742 57th St Sacramento CA 95817-2402 |
| Practice Telephone | 9165382477 |
| Mailing Telephone | 9165084069 |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |
| Authorized Official Name | RACHAEL SMITH (OWNER) |
| Authorized Official Telephone | 9169553149 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
A93664 | CA | Ambulatory Health Care Facilities |
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
A93664 | CA | Ambulatory Health Care Facilities |
| Street Address |
2001 N ST SUITE 100 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95811-4237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154891190 | Teresa Sy | Behavior Technician | 610 Bercut Dr. Suite B, Sacramento, CA 95811 | 2018-12-03 |
| 1669948212 | Micaela Badue | Counselor | 401 S St., Sacramento, CA 95811 | 2018-10-22 |
| 1669956801 | Andrea Martinez | Counselor | 600 Bercut Dr., Sacramento, CA 95811 | 2018-09-24 |
| 1174000855 | Clinicians Connect Care Home Health & Hospice Services | Home Health | 716 19th Street, Suite 200, Sacramento, CA 95811 | 2018-07-25 |
| 1992202345 | Benjamin James Leibold | Behavior Technician | 610 Bercut Drive, Suite B, Sacramento, CA 95811 | 2018-04-11 |
| 1669979233 | Aja Jones | Counselor | 401 S Street, Sacramento, CA 95811 | 2018-04-10 |
| 1821511916 | Lucas John Monaco | Counselor | 1400 North 'a' Street, Bldg A, Sacramento, CA 95811 | 2017-07-20 |
| 1275089963 | Sergio Vicuna, D.d.s., Inc | Dentist | 1804 19th St, Suite 100, Sacramento, CA 95811 | 2016-09-01 |
| 1386057495 | Chelsea Turner | Counselor | 600 Bercut Drive, Sacramento, CA 95811 | 2014-06-05 |
| 1427473636 | Sidney Caldwell | Counselor | 401 S Street Sacramento, Sacramento, CA 95811 | 2014-02-25 |
| Find all providers in zip 95811 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467898106 | Reset Youth Treatment Enterprises | Clinic/Center | 3725 Marysville Boulevard, Suite 337, Sacramento, CA 95838 | 2013-05-21 |
| 1427325240 | Sacramento Children's Home | Clinic/Center | 2751 Wilmington Ave, Sacramento, CA 95820 | 2011-11-22 |
| 1225356819 | County of Sacramento | Clinic/Center | 2140 Stockton Blvd, Sacramento, CA 95817-1337 | 2010-05-07 |
| 1255537536 | River Oak Center for Children | Clinic/Center | 1238 S Street, Sacramento, CA 95814 | 2007-06-25 |
| 1992913883 | Heartland Child & Family Services | Clinic/Center | 477 Las Palmas Ave, Sacramento, CA 95815-1605 | 2007-05-21 |
| 1093921009 | Chw Medical Foundation | Clinic/Center | 3066 Freeport Blvd, Sacramento, CA 95818-4349 | 2007-05-15 |
| 1932314184 | Asian Pacific Community Counseling | Clinic/Center | 7273 14th Ave, Suite 120-b, Sacramento, CA 95820 | 2007-05-11 |
| 1598811952 | River Oak Center for Children | Clinic/Center | 2751 9th Ave, Sacramento, CA 95818-4406 | 2007-01-26 |
| 1780730143 | River Oak Center for Chilren | Clinic/Center | 7322 Florinda Way, Sacramento, CA 95828-4015 | 2007-01-26 |
| 1730234907 | River Oak Center for Children | Clinic/Center | 4322 4th Ave, Sacramento, CA 95817-3023 | 2007-01-25 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95811 |
Please comment or provide details below to improve the information on SACRAMENTO CHILD AND ADOLESCENT WELLNESS CENTER CORP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.