Healthcare Provider Details
I. General information
NPI: 1265573349
Provider Name (Legal Business Name): COUNTY OF MADERA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/09/2007
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1604 SUNRISE AVE
MADERA CA
93638-4926
US
IV. Provider business mailing address
1604 SUNRISE AVE
MADERA CA
93638-4926
US
V. Phone/Fax
- Phone: 559-675-7893
- Fax: 559-661-2815
- Phone: 559-675-7893
- Fax: 559-661-2815
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QF0050X |
| Taxonomy | Non-Surgical Family Planning Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP0905X |
| Taxonomy | State or Local Public Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SEAN
KIRKPATRICK
Title or Position: DEPUTY DIRECTOR
Credential:
Phone: 559-675-7703