MEDICARE: VALLEY CHILDREN'S HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	040000416	CA
2	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710058151
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY CHILDREN'S HOSPITAL

Provider Business Mailing Address
First Line	:	5085 E MCKINLEY AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93727-1964
Country	:	US
Telephone Number	:	559-353-7125
Fax Number	:	559-353-7460

Provider Business Practice Location Address
First Line	:	5085 E MCKINLEY AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93727-1964
Country	:	US
Telephone Number	:	559-353-7125
Fax Number	:	559-353-7461

Authorized Official
Title or Position	:	SENIOR VP AND CFO
Name	:	TINA MYCROFT
Credential	:
Telephone Number	:	559-353-7090

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	01/14/2025

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Directions to “VALLEY CHILDREN'S HOSPITAL ” Practice Location

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