Provider Demographics
NPI:1225067176
Name:SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Entity type:Organization
Organization Name:SUTTER VISITING NURSE ASSOCIATION AND HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-864-4840
Mailing Address - Street 1:5099 COMMERCIAL CIR STE 208
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-1374
Mailing Address - Country:US
Mailing Address - Phone:707-864-4840
Mailing Address - Fax:707-863-9063
Practice Address - Street 1:1900 BATES AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-8587
Practice Address - Country:US
Practice Address - Phone:925-677-4240
Practice Address - Fax:925-687-9347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05-7004Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER