Healthcare Provider Details

I. General information

NPI: 1316080609
Provider Name (Legal Business Name): PRIMER PASO INSTITUTE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 N CHURCH ST
VISALIA CA
93291-5009
US

IV. Provider business mailing address

310 N CHURCH ST
VISALIA CA
93291-5009
US

V. Phone/Fax

Practice location:
  • Phone: 559-734-6042
  • Fax: 559-635-4788
Mailing address:
  • Phone: 559-734-6042
  • Fax: 559-635-4788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number5416
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number540009CN
License Number StateCA

VIII. Authorized Official

Name: RICARDO VASQUEZ
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW
Phone: 559-734-6042