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General NPI Number Information
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NPI Number | 1427269521
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Entity Type | Organization
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Legal Business Name | UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 121 BARBOZA ST
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City | MENDOTA
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State | CA
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Zip | 93640-1901
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Country | US
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Telephone | 559-655-5000
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Fax | 559-655-6818
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Provider Business Mailing Address
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Address Line | 3875 W BEECHWOOD AVE
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City | FRESNO
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State | CA
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Zip | 93711-0795
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Country | US
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Telephone | 800-492-4227
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Fax | 559-646-6614
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Authorized Official
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Title or Position | DIRECTOR OF BILLING
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Name | MARY LOU LOPEZ
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Credential |
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Telephone | 800-492-4227
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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 | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 040000313
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License Number State | CA
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