NPI 1043249204
Department of State Hospitals
Practice location
- Address
- 3102 E Highland Ave, Patton, CA 92369-7813
- Phone
- (909) 425-7552
- Fax
- (909) 425-6407
- Mailing address
- 1215 O Street, Ms-3 Patient Cost Recovery Section, Sacramento, CA 95814-6414
Authorised official
- Name
- Guadalupe M Alonzo-Diaz
- Title
- Administrative Deputy Director
- Phone
- (916) 654-2655
Registered specialties (6)
Psychiatric Hospital
Primary
Forensic Psychologist
General Acute Care Hospital
Mental Illness Intermediate Care Facility
Long Term Care Pharmacy
Registry record
- NPI
- 1043249204
- Entity type
- Organization
- NPI issued
- 1 Jul 2006
- Record last updated
- 28 Jun 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.