Basic Information
| Provider Information | |||||||||
| NPI: | 1922597681 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SIERRA VIEW LOCAL HEALTH CARE DISTRICT | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | SIERRA VIEW COMMUNITY HEALTH CENTER-STRATHMORE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 465 W PUTNAM AVE | ||||||||
| Address2: | |||||||||
| City: | PORTERVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932573320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5597841110 | ||||||||
| FaxNumber: | 5597886136 | ||||||||
| Practice Location | |||||||||
| Address1: | 19631 ROAD 224 | ||||||||
| Address2: | |||||||||
| City: | STRATHMORE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93267 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5597841110 | ||||||||
| FaxNumber: | 5597886136 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2018 | ||||||||
| LastUpdateDate: | 05/08/2018 | ||||||||
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| AuthorizedOfficialLastName: | ZEBOSKEY | ||||||||
| AuthorizedOfficialFirstName: | DEBORAH | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | HIM DIRECTOR/CHIEF PRIVACY OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 5597886066 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
ID Information
| ID | Type | State | Issuer | Description | 0 | 01 | WILL BE APPLYING FOR MEDICAID, DO NOT HAVE A NUMBER ASSIGNED AT THIS MOMENT | OTHER |