Healthcare Provider Details

I. General information

NPI: 1073721791
Provider Name (Legal Business Name): UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 06/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 11TH ST
ORANGE COVE CA
93646-2211
US

IV. Provider business mailing address

PO BOX 790
PARLIER CA
93648-0790
US

V. Phone/Fax

Practice location:
  • Phone: 559-626-4031
  • Fax: 559-626-4963
Mailing address:
  • Phone: 559-646-3561
  • Fax: 559-646-3642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number040000129
License Number StateCA

VIII. Authorized Official

Name: MS. COLLEEN CURTIS
Title or Position: CEO
Credential:
Phone: 559-646-6618