Basic Information
| Provider Information | |||||||||
| NPI: | 1184758864 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CONSUMERS SELF HELP CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1851 HERITAGE LN STE 187 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958154922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9163333800 | ||||||||
| FaxNumber: | 9165501777 | ||||||||
| Practice Location | |||||||||
| Address1: | 2500 MARCONI AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958214856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164854175 | ||||||||
| FaxNumber: | 9164252673 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2007 | ||||||||
| LastUpdateDate: | 06/01/2020 | ||||||||
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| AuthorizedOfficialLastName: | STANTON | ||||||||
| AuthorizedOfficialFirstName: | MEGHAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9163333800 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251V00000X | Y | Agencies | Voluntary or Charitable |
ID Information
| ID | Type | State | Issuer | Description | 01268508 | 05 | CA | MEDICAID |