Healthcare Provider Details

I. General information

NPI: 1407996002
Provider Name (Legal Business Name): WESTCARE CALIFORNIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/31/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 E BELMONT AVE
FRESNO CA
93701-1502
US

IV. Provider business mailing address

1900 N GATEWAY BLVD
FRESNO CA
93727-1622
US

V. Phone/Fax

Practice location:
  • Phone: 559-251-8400
  • Fax: 559-453-6969
Mailing address:
  • Phone: 559-251-4800
  • Fax: 559-453-6969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number100010IN
License Number StateCA

VIII. Authorized Official

Name: SHAWN A JENKINS
Title or Position: COO
Credential:
Phone: 702-385-2090