Healthcare Provider Details

I. General information

NPI: 1780963140
Provider Name (Legal Business Name): CALIFORNIA HEALTH COLLABORATIVE FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 W SHAW AVE
FRESNO CA
93711-3504
US

IV. Provider business mailing address

1680 W SHAW AVE
FRESNO CA
93711-3504
US

V. Phone/Fax

Practice location:
  • Phone: 559-221-6315
  • Fax:
Mailing address:
  • Phone: 559-221-6315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN RAMIREZ
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 559-244-4524