Healthcare Provider Details
I. General information
NPI: 1770204752
Provider Name (Legal Business Name): CAMARENA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/07/2022
Last Update Date: 09/07/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16911 HILL DR
MADERA CA
93638-2838
US
IV. Provider business mailing address
PO BOX 299
MADERA CA
93639-0299
US
V. Phone/Fax
- Phone: 559-664-4000
- Fax: 559-675-5625
- Phone: 559-664-4000
- Fax: 559-675-5625
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINE
N.
HOWLAND
Title or Position: CHIEF OPERATIONS OFFICER
Credential:
Phone: 559-664-4000