Basic Information
| Provider Information | |||||||||
| NPI: | 1659036754 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DELICANA | ||||||||
| FirstName: | RICHMON | ||||||||
| MiddleName: | REYES | ||||||||
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| Mailing Information | |||||||||
| Address1: | SACRAMENTO COUNTY MENTAL HEALTH TREATMENT CENTER | ||||||||
| Address2: | 2150 STOCKTON BLVD. | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9168751000 | ||||||||
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| Practice Location | |||||||||
| Address1: | SACRAMENTO COUNTY MENTAL HEALTH TREATMENT CENTER | ||||||||
| Address2: | 2150 STOCKTON BLVD. | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9168751000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2021 | ||||||||
| LastUpdateDate: | 11/03/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 95193643 | CA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.