Provider Demographics
NPI:1104434372
Name:SIERRA COUNTY
Entity type:Organization
Organization Name:SIERRA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:SZOPA
Authorized Official - Suffix:
Authorized Official - Credentials:SUDCC II
Authorized Official - Phone:530-993-6746
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:DOWNIEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95936-0038
Mailing Address - Country:US
Mailing Address - Phone:530-289-3711
Mailing Address - Fax:530-289-3716
Practice Address - Street 1:22 MAIDEN LN
Practice Address - Street 2:
Practice Address - City:DOWNIEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95936
Practice Address - Country:US
Practice Address - Phone:530-289-3711
Practice Address - Fax:530-289-3716
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIERRA COUNTY MENTAL HEALTH,DRUG,ALCOHOL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-14
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1114145752OtherNPI FOR OUR OTHER LOCATION