Healthcare Provider Details

I. General information

NPI: 1932329091
Provider Name (Legal Business Name): CENTRAL VALLEY INDIAN HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2007
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32938 ROAD 222 SUITE 2
NORTH FORK CA
93643-9562
US

IV. Provider business mailing address

2740 HERNDON AVE
CLOVIS CA
93611-6813
US

V. Phone/Fax

Practice location:
  • Phone: 559-299-4264
  • Fax: 559-299-1421
Mailing address:
  • Phone: 559-299-4264
  • Fax: 559-299-1421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number040000038
License Number StateCA

VIII. Authorized Official

Name: JULIE A RAMSEY
Title or Position: COO
Credential:
Phone: 559-299-2578