Healthcare Provider Details

I. General information

NPI: 1902025059
Provider Name (Legal Business Name): CENTRAL VALLEY INDIAN HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29323 AUBERRY RD
PRATHER CA
93651-9757
US

IV. Provider business mailing address

2740 HERNDON AVE
CLOVIS CA
93611-6813
US

V. Phone/Fax

Practice location:
  • Phone: 559-855-5390
  • Fax: 559-299-0245
Mailing address:
  • Phone: 559-299-2578
  • Fax: 559-299-1421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number040000392
License Number StateCA

VIII. Authorized Official

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