Healthcare Provider Details

I. General information

NPI: 1396399101
Provider Name (Legal Business Name): WESTCARE CALIFORNIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2019
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 23RD ST
RICHMOND CA
94804-1830
US

IV. Provider business mailing address

1900 N GATEWAY BLVD
FRESNO CA
93727-1622
US

V. Phone/Fax

Practice location:
  • Phone: 559-251-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE LEE ALLEN
Title or Position: QUALITY ASSURANCE ASSISTANT
Credential:
Phone: 559-251-4800