Healthcare Provider Details

I. General information

NPI: 1851495105
Provider Name (Legal Business Name): COUNTY OF TULARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2006
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 W HENDERSON AVE
PORTERVILLE CA
93257-1490
US

IV. Provider business mailing address

5957 S MOONEY BLVD
VISALIA CA
93277-9394
US

V. Phone/Fax

Practice location:
  • Phone: 559-788-1200
  • Fax:
Mailing address:
  • Phone: 559-624-8000
  • Fax: 559-737-4697

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 State

VIII. Authorized Official

Name: NATALIE BOLIN
Title or Position: DIRECTOR OF MENTAL HEALTH
Credential:
Phone: 559-624-7445