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General NPI Number Information
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NPI Number | 1588725972
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Entity Type | Organization
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Legal Business Name | SAN JOAQUIN FAMILY HEALTHCARE ASSOCIATION, INC
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 08/05/2022
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Provider Practice Location Address
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Address Line | 12683 AVE 416
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City | OROSI
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State | CA
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Zip | 93647
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Country | US
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Telephone | 559-528-4717
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Fax | 559-528-4717
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Provider Business Mailing Address
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Address Line | 12683 AVE 416
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City | OROSI
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State | CA
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Zip | 93647
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Country | US
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Telephone | 559-528-4717
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Fax | 559-528-0302
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KRISTIE STRAND
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Credential | RN
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Telephone | 559-528-4717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 120000641
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License Number State | CA
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