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NPI Code Detail

MEDICARE: FAMILY HEALTHCARE NETWORK

MEDICARE: FAMILY HEALTHCARE NETWORK
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
1171M00000XCase Manager/Care Coordinator
2261QF0400XFederally Qualified Health Center (FQHC)

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A0-1183OTHERCAMEDICARE ID - TYPE UNSPECIFIED
2ZZZ19552ZOTHERCAMEDICARE ID - TYPE UNSPECIFIED

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902547789
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY HEALTHCARE NETWORK
Provider Business Mailing Address
First Line : 305 E CENTER AVE
Second Line :
City : VISALIA
State : CA
Zip : 93291-6331
Country : US
Telephone Number : 559-737-4700
Fax Number : 559-741-8414
Provider Business Practice Location Address
First Line : 1344 W CLINTON AVE
Second Line :
City : FRESNO
State : CA
Zip : 93705-3805
Country : US
Telephone Number : 559-737-4700
Fax Number : 559-741-8414
Authorized Official
Title or Position : PRESIDENT & CEO
Name : KERRY L HYDASH
Credential :
Telephone Number : 559-737-4700
Provider Enumeration Date : 04/05/2022
Last Update Date : 02/28/2024

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Directions to “FAMILY HEALTHCARE NETWORK ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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