Provider Demographics
NPI:1396123568
Name:SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Entity type:Organization
Organization Name:SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-864-4665
Mailing Address - Street 1:4830 BUSINESS CENTER DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-1689
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:455 OCONNOR DR
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1633
Practice Address - Country:US
Practice Address - Phone:408-277-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUTTER HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-08
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty