Healthcare Provider Details

I. General information

NPI: 1407304678
Provider Name (Legal Business Name): COUNTY OF TULARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2016
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

942 S SANTA FE ST
VISALIA CA
93292-2912
US

IV. Provider business mailing address

5957 S MOONEY BLVD
VISALIA CA
93277-9394
US

V. Phone/Fax

Practice location:
  • Phone: 559-636-4000
  • Fax: 559-624-1067
Mailing address:
  • Phone: 559-624-7445
  • Fax: 559-624-1067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number540002HN
License Number StateCA

VIII. Authorized Official

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