Sacramento Street Medicine

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

Legal business name

SACRAMENTO STREET MEDICINE

Practice address

2211 Del Paso Blvd
Sacramento, CA 95815-3101

Phone

(916) 720-2237

Fax

(800) 815-8510

NPI assigned

Aug 23, 2022

Last updated

Dec 17, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anthony Menacho, PA-CNPI 1386290195

Title

Executive Director

Phone

(909) 730-5241

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony Menacho, PA-C

  • Physician Assistant
  • Woodland, CA
  • NPI 1386290195
  NPD Authorized official

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1548989692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2917 GRAYSON WAY",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "95670",
            "telephone_number": "916-800-4054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 DEL PASO BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958153101",
            "telephone_number": "916-720-2237",
            "fax_number": "800-815-8510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2917 Grayson Way",
            "address_purpose": "LOCATION",
            "city": "Rancho Cordova",
            "state": "CA",
            "postal_code": "95670",
            "country_code": "US",
            "telephone_number": "916-800-4054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SACRAMENTO STREET MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "MENACHO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-730-5241",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sacramento Self Help Housing, Inc.
• Sacramento Sierra Rehabilitation Hospital, LLC (UC Davis Rehabilitation Hospital)
• Sacramento Skilled Nursing and Long Term Care Medical Group Inc.
• Sacramento Spinal Specialists an Oliver Chiropractic Corp.
• Sacramento Spine Diagnostic and Rehab Center, Inc
• Sacramento Supportive Housing LLC
• Sacramento Surgery Center Associates, L P (Capitol City Surgery Center)
• Sacramento Transformation Center
• Sacramento Ultrasound, Inc.
• Sacramento Valley Ambulance Inc.

• Public Health & General Preventive Medicine Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Public Health & General Preventive Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.