MEDICARE: TURNING POINT OF CENTRAL CALIFORNIA, INC.

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	540007BN	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	540007BN	OTHER	CA	ADP CERTIFICATION
2	5478	OTHER	CA	DRUG MEDI-CAL

General Provider Information

NPI Number	:	1861619314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TURNING POINT OF CENTRAL CALIFORNIA, INC.

Provider Business Mailing Address
First Line	:	220 N LOCUST ST
Second Line	:
City	:	VISALIA
State	:	CA
Zip	:	93291-4946
Country	:	US
Telephone Number	:	559-627-1385
Fax Number	:	559-636-2105

Provider Business Practice Location Address
First Line	:	14871 ROAD 192
Second Line	:
City	:	PORTERVILLE
State	:	CA
Zip	:	93257-9305
Country	:	US
Telephone Number	:	559-741-8162
Fax Number	:	559-636-2105

Authorized Official
Title or Position	:	CHIEGE EXECUTIVE OFFICER
Name	:	JEFF FLY
Credential	:
Telephone Number	:	559-732-8086

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	08/22/2020

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