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General NPI Number Information
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NPI Number | 1174130942
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Entity Type | Organization
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Legal Business Name | KAWEAH DELTA HEALTH CARE DISTRICT
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Dates
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Enumeration Date | 09/25/2020
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 1000 N MOONEY BLVD
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City | TULARE
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State | CA
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Zip | 93274-2417
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Country | US
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Telephone | 559-624-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 400 W MINERAL KING AVE
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City | VISALIA
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State | CA
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Zip | 93291-6237
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP/CFO
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Name | MALINDA TUPPER
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Credential |
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Telephone | 559-624-4065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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