Healthcare Provider Details

I. General information

NPI: 1114604915
Provider Name (Legal Business Name): KINGS VIEW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 11/03/2023
Certification Date: 11/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 S C ST
PORTERVILLE CA
93257-4822
US

IV. Provider business mailing address

1396 W HERNDON AVE
FRESNO CA
93711-7126
US

V. Phone/Fax

Practice location:
  • Phone: 559-334-6410
  • Fax:
Mailing address:
  • Phone: 559-256-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: BELINDA ESPINO
Title or Position: ADMIN MANAGER
Credential:
Phone: 559-256-7632