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General NPI Number Information
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NPI Number | 1861169997
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Entity Type | Organization
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Legal Business Name | CENTRAL VALLEY BEHAVIORAL HEALTH PSYCHOLOGY CORPORATION
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Dates
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Enumeration Date | 08/26/2021
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 1933 N FILBERT AVE
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City | CLOVIS
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State | CA
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Zip | 93619-4297
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Country | US
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Telephone | 559-326-7775
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Fax |
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Provider Business Mailing Address
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Address Line | 1781 E FIR AVE STE 101
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City | FRESNO
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State | CA
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Zip | 93720-3865
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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 | CEO
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Name | MATTHEW TATUM
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Credential |
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Telephone | 559-326-7775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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