Organization Active NPI

At Provider Group of California PC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Sacramento, CA
National Provider Identifier
1700580305
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
AT PROVIDER GROUP OF CALIFORNIA PC
Practice address
3550 Watt Ave Ste 140
Sacramento, CA 95821-2666
Phone
(845) 769-8758
NPI assigned
Mar 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Authorized official

Name
Renee Mullings, LCADC III
Title
Director of Compliance
Phone
(951) 691-9101

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

3550 Watt Ave Ste 140
Sacramento, CA 95821-2666

Mailing address

PO Box 96634
Phoenix, AZ 85072-6634
Phone (845) 769-8758

National Provider Directory

National Provider Directory

Locations

3550 Watt Ave
Ste 140
Sacramento, CA 95821
Phone (916) 804-4471

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1700580305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96634",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850726634",
            "telephone_number": "845-769-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 WATT AVE STE 140",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958212666",
            "telephone_number": "845-769-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT PROVIDER GROUP OF CALIFORNIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-28",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "MULLINGS",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "951-691-9101",
        "authorized_official_credential": "LCADC III"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 13, 2026; 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.