California State University, Sacramento Student Health Center

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

License

261846341 Issued in CA

Legal business name

CALIFORNIA STATE UNIVERSITY, SACRAMENTO STUDENT HEALTH CENTER

Practice address

6000 J Street
Sacramento, CA 95819-6045

Phone

(916) 278-6035

NPI assigned

Aug 21, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeanne Marie Harris Van Dahlen

Title

Senior Associate Vice President

Phone

(916) 278-1772

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

California State University Sacramento Student Health Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• California State University, Sacramento

  • Clinic Pharmacy
  • Sacramento, CA
  • NPI 1972524924
  NPD tax ID
• California State University, Sacramento Student Health Center

  • Clinical Medical Laboratory
  • Sacramento, CA
  • NPI 1538279195
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1376659896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 J STREET",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958196045",
            "telephone_number": "916-278-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 J STREET",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958196045",
            "telephone_number": "916-278-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA STATE UNIVERSITY, SACRAMENTO STUDENT HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "HARRIS VAN DAHLEN",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "SENIOR ASSOCIATE VICE PRESIDENT",
        "authorized_official_telephone_number": "916-278-1772"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "CA",
            "license": "261846341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR00090480",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "1376659896",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• California Partnership to End Domestic Violence
• California Rehabilitation Equipment, Inc.
• California Reproductive Surgery, Inc
• California Sleep Solutions, LLC
• California State University, Sacramento
• California State University, Sacramento Student Health Center
• Mark David Caliguire
• Bianca Noel Calio, MD
• Jamee F Calisa, RD
• Karen Denise Calisterio

• Student Health Clinic/Center in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Student Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.