ELICA HEALTH CENTERS NPI 1790419059

NPI Information

NPI: 1790419059
Provider Name: ELICA HEALTH CENTERS
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 05D2270998

Address:
2400 GLENDALE LN
SACRAMENTO, CA
ZIP 95825
Phone: (916) 454-2345
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ELICA HEALTH CENTERS is a federally qualified health center (fqhc) clinic center in Sacramento, CA. ELICA HEALTH CENTERS NPI is 1790419059. The provider is registered as an organization entity type.

The provider's business location address is:

2400 GLENDALE LN
SACRAMENTO, CA
ZIP 95825-431
Phone: (916) 454-2345

The provider's authorized official is Tatyana Bak .
The authorized official title is Ceo and has the following contact phone number (916) 569-8484.

The CLIA number assigned to this NPI record is 05D2270998 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/13/2022 and was last updated on 7/13/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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