Provider Demographics
NPI:1033144464
Name:SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Entity type:Organization
Organization Name:SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT (CEO)
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-771-0328
Mailing Address - Street 1:5099 COMMERCIAL CIR STE 208
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-1374
Mailing Address - Country:US
Mailing Address - Phone:855-771-0328
Mailing Address - Fax:707-863-9043
Practice Address - Street 1:3001 LAVA RIDGE CT
Practice Address - Street 2:STE 330B
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3094
Practice Address - Country:US
Practice Address - Phone:916-797-7850
Practice Address - Fax:855-755-6414
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-12
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA051652Medicare Oscar/Certification