ELICA HEALTH CENTERS – NPI #1366068553
Clinic/Center

ELICA HEALTH CENTERS is an AHC clinic located in WEST SACRAMENTO, CA. NPPES has assigned the NPI number 1366068553 to ELICA HEALTH CENTERS on June 23, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. ELICA HEALTH CENTERS is also known by the name ELICA HEALTH CENTERS - HEALTH ON WHEELS 4. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 4 years ago on Mar 08, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ELICA HEALTH CENTERS below.

NPI Profile for
ELICA HEALTH CENTERS

NPI Number
1366068553
Enumeration Date

(about 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ELICA HEALTH CENTERS
Other Name: ELICA HEALTH CENTERS - HEALTH ON WHEELS 4
Primary location
1276 HALYARD DR
WEST SACRAMENTO, CA 95691-3412
Phone: (916) 454-2345 Fax:
Mailing address
1860 HOWE AVE STE 440
SACRAMENTO, CA 95825-1098
Phone: (916) 569-8484 Fax:
Organization Subpart
Yes - ELICA HEALTH CENTERS is subpart of another organization.
Authorized Official
TATYANA BAK
CEO
Phone: (916) 569-8484
Updated
Certification Date
Mar 08, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)
171M00000X
- Case Manager/Care Coordinator

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.