DIGNITY HEALTH MEDICAL FOUNDATION


Address: 1792 Tribute Rd, Suite 350, Sacramento, CA 95815-4305
Phone: 9169246400

DIGNITY HEALTH MEDICAL FOUNDATION (NPI# 1942334339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1942334339
Entity Type Organization
Organization Name DIGNITY HEALTH MEDICAL FOUNDATION
Other Organization Name MERCY MEDICAL GROUP, A SERVICE OF DIGNITY HEALTH MEDICAL FOUNDATION
Practice Address 1792 Tribute Rd
Suite 350
Sacramento
CA 95815-4305
Mailing Address Po Box 60000
File #72938
San Francisco
CA 94160-2938
Practice Telephone 9169246400
Practice Fax Number 9166489869
Mailing Telephone 9167333397
Enumeration Date 2007-03-15
Last Update Date 2014-12-17
Authorized Official Name GEORGE LENZI (CHIEF FINANCIAL OFFICER)
Authorized Official Telephone 9168512559
Is Organization Subpart Y
Parent Organization Name DIGNITY HEALTH MEDICAL FOUNDATION

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0855X Clinic/Center
Specialization: Adolescent and Children Mental Health
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
BSCA PRO FEES ZZZ29342Z 01
CA GR006356C 05
HEALTH NET 195 01
BLUE SHIELD ZZZ60278Z 01
CIGNA 0019838 01
HEALTH NET 983 01
SPECIAL PURPOSE TAX ID # 341996544 01
DME SUPPLIER # 476040021 01

Other Provider/Organization Names

Other Name Type Code
Mercy Medical Group, a service of Dignity Health Medical Foundation Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1710129275 Dignity Health Medical Foundation Clinic/Center 105 Dean Way, Folsom, CA 95630-2801 2009-03-30
1447492905 Dignity Health Medical Foundation Clinic/Center 6060 Watt Ave, North Highlands, CA 95660-4212 2009-03-30
1366684821 Dignity Health Medical Foundation Clinic/Center 10487 White Rock Rd, Rancho Cordova, CA 95670-5530 2009-03-30
1558495937 Dignity Health Medical Foundation Clinic/Center 7911 Laguna Blvd, Elk Grove, CA 95758-7920 2007-03-15
1780226852 Dignity Health Medical Foundation Clinic/Center 17051 Sierra Lakes Pkwy Ste 101, Fontana, CA 92336-1274 2019-10-10
1568989200 Dignity Health Medical Foundation Clinic/Center 3400 Data Dr, Rancho Cordova, CA 95670-7956 2017-08-24
1477074474 Dignity Health Medical Foundation Clinic/Center 3400 Data Dr, Rancho Cordova, CA 95670-7956 2017-06-29
1679019798 Dignity Health Medical Foundation Clinic/Center 6615 Valley Hi Dr, Sacramento, CA 95823-7076 2017-01-12
1508222647 Dignity Health Medical Foundation Clinic/Center 18406 Roscoe Blvd, Northridge, CA 91325-4107 2016-01-05
1376926527 Dignity Health Medical Foundation Clinic/Center 17051 Sierra Lakes Pkwy, Suite 101, Fontana, CA 92336-1274 2015-07-07

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities DIGNITY HEALTH MEDICAL FOUNDATION 3400 Data Dr, Rancho Cordova, CA 95670-7956

Office Location

Street Address 1792 TRIBUTE RD
SUITE 350
City SACRAMENTO
State CA
Zip Code 95815-4305

Providers in the same location

NPI Name Taxonomy Address Enumeration
1497757686 Jeffrey P Ruderman Obstetrics & Gynecology 1792 Tribute Rd, Suite 200, Sacramento, CA 95815-4305 2005-06-01
1962836254 Teresa Brown Dietitian, Registered 1792 Tribute Rd, Suite 200, Sacramento, CA 95815-4305 2013-08-22
1598949430 David C. Hsu Psychiatry & Neurology 1792 Tribute Rd, Suite 350, Sacramento, CA 95815-4305 2007-12-27
1073647020 Chw Medical Foundation Clinic/Center 1792 Tribute Rd, Suite 350, Sacramento, CA 95815-4305 2007-03-14
1053446385 Howard B. Spivak Counselor 1792 Tribute Rd, Suite 350, Sacramento, CA 95815-4305 2007-02-23
1841337011 Sacramento Maternal Fetal Medicine Medical Group, Inc. Specialist 1792 Tribute Rd, Suite 200, Sacramento, CA 95815-4305 2007-01-30
1982762787 Theodore Hoffman Psychiatry & Neurology 1792 Tribute Rd, Suite 350, Sacramento, CA 95815-4305 2006-12-05
1770651622 Meryl B. Rappaport Social Worker 1792 Tribute Rd, Suite 350, Sacramento, CA 95815-4305 2006-11-30
1144309543 Patricia Coan Hanson Social Worker 1792 Tribute Rd, Suite 350, Sacramento, CA 95815-4305 2006-11-04
1881773281 Bonnie Jacobson Marriage & Family Therapist 1792 Tribute Rd, Suite 350, Sacramento, CA 95815-4305 2006-11-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255958187 Douglas Benjamin Gudeman Counselor Alternative House-residential Treatment Center, 1550 Juliesse Avenue, Sacramento, CA 95815 2020-06-26
1366091894 Twin Rivers Unified School District Supports Brokerage 3051 Fairfield Street, Sacramento, CA 95815 2019-09-07
1669941159 Maria Luisa Plasencia Registered Nurse Martin Luther King Jr. Technology Academy, 3051 Fairfield St, Sacramento, CA 95815 2018-11-14
1700386547 Rww Outpatient Rehab Services, LLC Clinic/Center 1610 Arden Way Ste 195, Sacramento, CA 95815 2018-02-19
1114439262 Ahc Healthcare of Sacramento Corporation Skilled Nursing Facility 1411 Expo Pkwy, Sacramento, CA 95815 2017-10-30
1588173686 Rebekah Collette Curtis Counselor 1048 Dixieanne Ave. #28, Sacramento, CA 95815 2017-09-21
1497284145 Prohealth Home Care Inc Hospice Care, Community Based 1375 Exposition Blvd Suite 250b, Sacramento, CA 95815 2017-06-07
1386982296 Shailesh M Asaikar Md Inc Clinic/Center 1111 Exposition Blvd., Bldg 700, Sacramento, CA 95815 2013-01-28
1609129618 Jackey Care's Housing Clinic/Center 2447 Boxwood St, Sacramento, CA 95815 2012-10-16
1144549304 Rowena Deleon Nolasco Nurse Practitioner 577 Las Palmas Ave., Health for All, Sacremento, CA 95815 2010-05-26
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Taxonomy Information

Taxonomy Code 261QM0855X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adolescent and Children Mental Health

Taxonomy Definition

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]

Providers in the same taxonomy and city

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
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Competitor

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City SACRAMENTO
Zip Code 95815

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Dataset Information

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.

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