Healthcare Provider Details
I. General information
NPI: 1710207162
Provider Name (Legal Business Name): TULARE COUNTY OFFICE OF EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/08/2010
Last Update Date: 08/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11535 AVENUE 264
VISALIA CA
93277
US
IV. Provider business mailing address
2637 W BURREL AVE PO BOX 5091
VISALIA CA
93291-4511
US
V. Phone/Fax
- Phone: 559-747-3984
- Fax: 559-747-3642
- Phone: 559-747-3984
- Fax: 559-747-3642
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
RONALD
C
PEKAREK
Title or Position: PROGRAM MANAGER
Credential: MA, PPS, BCBA
Phone: 559-747-3984