Healthcare Provider Details

I. General information

NPI: 1215741020
Provider Name (Legal Business Name): CLOVIS GLOBAL ACADEMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 SHAW AVE
CLOVIS CA
93612-3802
US

IV. Provider business mailing address

1111 VAN NESS AVE
FRESNO CA
93721-2002
US

V. Phone/Fax

Practice location:
  • Phone: 559-575-0587
  • Fax:
Mailing address:
  • Phone: 559-265-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: DONALD TURNMIRE
Title or Position: PROGRAM SUPERVISOR
Credential: MS
Phone: 559-513-3362