Healthcare Provider Details

I. General information

NPI: 1518091743
Provider Name (Legal Business Name): FAMILY BUILDERS FOSTER CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 08/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 S FAIRWAY ST STE 104
VISALIA CA
93277
US

IV. Provider business mailing address

3300 S FAIRWAY ST STE 104
VISALIA CA
93277-8109
US

V. Phone/Fax

Practice location:
  • Phone: 559-685-1200
  • Fax: 559-685-9742
Mailing address:
  • Phone: 559-685-1200
  • Fax: 559-685-9742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number547202600
License Number StateCA

VIII. Authorized Official

Name: DR. JUDY DUBEAU
Title or Position: EXECUTIVE DIRECTOR
Credential: PH.D
Phone: 559-685-1200