Provider Demographics
NPI:1063113892
Name:TRIFECTA CARE HEALTH GROUP INC
Entity type:Organization
Organization Name:TRIFECTA CARE HEALTH GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-949-3632
Mailing Address - Street 1:1824 TRIBUTE RD STE B
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4308
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1824 TRIBUTE RD STE B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4308
Practice Address - Country:US
Practice Address - Phone:916-237-7219
Practice Address - Fax:510-327-0359
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRIFECTA CARE HEALTH GROUP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service