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Contact Information

WILFRED C BROOM
7171 BOWLING DRIVE SUITE 300
SACRAMENTO, CA95823
 Phone: 916-394-9195
 Fax: 916-392-2827
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Counselor

101Y00000X
 

Case Manager/Care Coordinator

171M00000X
 

Other Service Providers

175T00000X
Indicates primary specialty

NPI Profile & details for WILFRED C BROOM · (Male)

NPI Number 1750896288
Status Active
Credentials
Entity Individual
Enumeration date 12/06/2017
Last updated 01/04/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • CA Medicaid 1508011065
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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