NPIMap

Organization Active NPI

Step Up on Second Street, Inc

  • Community/Behavioral Health Agency
  • Sacramento, CA
National Provider Identifier
1528810413
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
STEP UP ON SECOND STREET, INC
Practice address
4600 Northgate Blvd Ste 235
Sacramento, CA 95834-1145
Phone
(916) 533-3177
NPI assigned
Apr 3, 2024
Last updated
Apr 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Authorized official

Name
David Mark Tavlin
Title
Chief Program Officer
Phone
(310) 985-5250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4600 Northgate Blvd Ste 235
Sacramento, CA 95834-1145

Mailing address

4600 Northgate Blvd Ste 235
Sacramento, CA 95834-1145
Phone (916) 533-3177

Other names 1

  • Step Up On Second -Sacramento Other name

National Provider Directory

National Provider Directory
Tax ID family
Step Up on Second Street Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

4600 Northgate Blvd
Ste 235
Sacramento, CA 95834
Phone (916) 533-3177

NPI Registry JSON

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1528810413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 NORTHGATE BLVD STE 235",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341145",
            "telephone_number": "916-533-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 NORTHGATE BLVD STE 235",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341145",
            "telephone_number": "916-533-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEP UP ON SECOND STREET, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "TAVLIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "CHIEF PROGRAM OFFICER",
        "authorized_official_telephone_number": "310-985-5250"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Step Up On Second -Sacramento",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.