Healthcare Provider Details

I. General information

NPI: 1124875240
Provider Name (Legal Business Name): STATE CENTER COMMUNITY COLLEGE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 N REED AVE
REEDLEY CA
93654-2017
US

IV. Provider business mailing address

995 N REED AVE
REEDLEY CA
93654-2017
US

V. Phone/Fax

Practice location:
  • Phone: 559-494-3028
  • Fax: 800-643-1067
Mailing address:
  • Phone: 559-494-3028
  • Fax: 800-643-1067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELANIE HIGHFILL
Title or Position: VP, ADMINISTRATIVE SERVICES
Credential:
Phone: 559-494-3000