Healthcare Provider Details

I. General information

NPI: 1063203750
Provider Name (Legal Business Name): FOR LOCAL COMMUNITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1624 K ST # F
MERCED CA
95340-4814
US

IV. Provider business mailing address

1624 K ST # F
MERCED CA
95340-4814
US

V. Phone/Fax

Practice location:
  • Phone: 209-215-5400
  • Fax:
Mailing address:
  • Phone: 209-215-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MONICA HERRERA
Title or Position: CEO
Credential:
Phone: 209-215-5400