Provider Demographics
NPI:1992875371
Name:PLACER COUNTY CCS
Entity type:Organization
Organization Name:PLACER COUNTY CCS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CCS ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:R
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:530-886-3676
Mailing Address - Street 1:11484 B AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-2603
Mailing Address - Country:US
Mailing Address - Phone:530-886-3630
Mailing Address - Fax:530-886-3613
Practice Address - Street 1:8951 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:CA
Practice Address - Zip Code:95658-9723
Practice Address - Country:US
Practice Address - Phone:916-415-4486
Practice Address - Fax:916-663-0212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACCS00125FMedicaid