Provider Demographics
NPI:1972619120
Name:CHW CHILDREN'S CENTER SOUTH
Entity type:Organization
Organization Name:CHW CHILDREN'S CENTER SOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KARAMJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:KALKAT
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:916-681-6300
Mailing Address - Street 1:6615 VALLEY HI DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-4601
Mailing Address - Country:US
Mailing Address - Phone:916-681-6300
Mailing Address - Fax:916-681-6354
Practice Address - Street 1:6615 VALLEY HI DR
Practice Address - Street 2:SUITE A
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-4601
Practice Address - Country:US
Practice Address - Phone:916-681-6300
Practice Address - Fax:916-681-6354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC42658101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty