JAIL PSYCH SERVICES - RCCC (NPI# 1598847519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598847519 |
| Entity Type | Organization |
| Organization Name | JAIL PSYCH SERVICES - RCCC |
| Practice Address |
12450 Bruceville Rd Elk Grove CA 95757-9784 |
| Practice Telephone | 9168745222 |
| Practice Fax Number | 9168748183 |
| Mailing Telephone | 9168745222 |
| Mailing Fax Number | 9168748183 |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. PAUL E HENDRICKS (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 9168745222 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2400X |
Clinic/Center Specialization: Prison Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | COUNTY MENTAL HEALTH # | 8413 | 01 |
| Street Address |
12450 BRUCEVILLE RD |
| City | ELK GROVE |
| State | CA |
| Zip Code | 95757-9784 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447896600 | Cassandra Jan Cassas I | Behavior Technician | 9832 Tundra Swan, Elk Grove, CA 95757 | 2019-11-22 |
| 1386287027 | Winslow Dds Inc. | Clinic/Center | 10043 Bruceville Road, Unit 160, Elk Grove, CA 95757 | 2019-10-25 |
| 1386206696 | Daniel & Max, LLC | Optometrist | 7150 Elk Grove Blvd, Elk Grove, CA 95757 | 2019-07-08 |
| 1033684865 | Lua Davidson | Behavioral Analyst | 5504 Aspen Grove Ln, Elk Grove, CA 95757 | 2018-10-08 |
| 1821578386 | Michele Elizabeth Amato | Behavior Technician | 8350 Lotz Parkway, Elk Grove, CA 95757 | 2018-08-15 |
| 1043759632 | Costco Wholesale Corporation | Pharmacy | 7400 Elk Grove Boulevard, Elk Grove, CA 95757 | 2017-02-16 |
| 1497207351 | Ron Dancy | Genetic Counselor, MS | 9864 West Taron Dr, Elk Grove, CA 95757 | 2016-10-26 |
| 1780051524 | Jesselle Pablo | Counselor | 10227 Pedra Do Sol Way, Elk Grove, CA 95757 | 2015-08-27 |
| 1851708945 | Yen Ngoc Hoang | Pharmacist | 8257 Hopewell Drive, Elk Grove, CA 95757 | 2014-07-21 |
| 1477742070 | Nkechi Akudo Nzerem-johnson | Pediatrics | Dignity Health Medical Plaza, 8220 Wymark Drive Suite 200, Elk Grove, CA 95757 | 2007-10-18 |
| Find all providers in zip 95757 | ||||
| Taxonomy Code | 261QP2400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Prison Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396169405 | California Correctional Health Care Services | Clinic/Center | 8280 Long Leaf Drive, D2-406, Elk Grove, CA 95758 | 2014-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801435631 | County of Sacramento | Clinic/Center | 651 I Street, Sacramento, CA 95814 | 2019-12-26 |
| 1801430418 | Federal Correctional Complex Lompoc | Clinic/Center | 3901 Klein Blvd, Lompoc, CA 93436-2706 | 2019-11-06 |
| 1861052060 | County of San Mateo | Clinic/Center | 1300 Maple St., Redwood City, CA 94063 | 2019-06-19 |
| 1750941977 | County of San Mateo | Clinic/Center | 300 Bradford St., Redwood City, CA 94063 | 2019-06-19 |
| 1669032868 | County of San Mateo | Clinic/Center | 222 Paul Scannell Dr., San Mateo, CA 94402 | 2019-06-19 |
| 1841620689 | Orange County Health Care Agency | Clinic/Center | 550 N. Flower Street, Santa Ana, CA 92706 | 2013-11-14 |
| 1154621555 | American Correctional Solutions, Inc. | Clinic/Center | 1588 N Batavia St, Orange, CA 92867-3553 | 2010-11-01 |
| 1104033661 | Jail Health Services Pharmacy | Clinic/Center | 1 Moreland Drive Cj#5 Pharmacy, San Bruno, CA 94066-1670 | 2007-05-16 |
| 1780181222 | Department of State Hospital Coalinga | Clinic/Center | 24511 W Jayne Ave, Coalinga, CA 93210-9516 | 2018-04-11 |
| 1467982017 | California Forensic Medical Group, Inc. | Clinic/Center | 5325 Broder Blvd, Dublin, CA 94568-3309 | 2017-06-15 |
| Find all providers with the same taxonomy | ||||
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| 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.