Provider Demographics
NPI:1730359845
Name:CALIFORNIA HISPANIC COMMISSION
Entity type:Organization
Organization Name:CALIFORNIA HISPANIC COMMISSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-443-5473
Mailing Address - Street 1:2101 CAPITOL AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5720
Mailing Address - Country:US
Mailing Address - Phone:916-443-5473
Mailing Address - Fax:916-443-1732
Practice Address - Street 1:40 ELDRIDGE AVE STE 10A
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-6823
Practice Address - Country:US
Practice Address - Phone:707-449-8014
Practice Address - Fax:707-449-8750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility