NPIMap

Organization Active NPI

Jail Psych Services - RCCC

  • Prison Health Clinic/Center
  • Elk Grove, CA
National Provider Identifier
1598847519
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
Legal business name
JAIL PSYCH SERVICES - RCCC
Practice address
12450 Bruceville Rd
Elk Grove, CA 95757-9784
Phone
(916) 874-5222
Fax
(916) 874-8183
NPI assigned
Oct 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Paul E Hendricks, RNNPI 1124034350
Title
Clinical Director
Phone
(916) 874-5222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X Primary

Addresses

Primary practice location

12450 Bruceville Rd
Elk Grove, CA 95757-9784

Mailing address

12450 Bruceville Rd
Elk Grove, CA 95757-9784
Phone (916) 874-5222

Other identifiers 1

IdentifierTypeStateIssuer
8413OtherCACOUNTY MENTAL HEALTH #

National Provider Directory

National Provider Directory
Tax ID family
Ucd Med GRP Pediatric32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Locations

12450 Bruceville Rd
Elk Grove, CA 95757
Phone (916) 874-5222

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598847519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12450 BRUCEVILLE RD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957579784",
            "telephone_number": "916-874-5222",
            "fax_number": "916-874-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 BRUCEVILLE RD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957579784",
            "telephone_number": "916-874-5222",
            "fax_number": "916-874-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAIL PSYCH SERVICES - RCCC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "916-874-5222",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNTY MENTAL HEALTH #",
            "identifier": "8413",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.