Organization
CSP-CORCORAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE GONZALES EDD (SENIOR SUPEVISOR (ACTING))
(559) 992-8800
Entity
Organization
Contact information
Practice address
4001 KING AVE, CORCORAN, CA 93212-9611
(559) 992-8800
Mailing address
4001 KING AVE, CORCORAN, CA 93212-9611
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
PSY21977
CA
Other
Enumeration date
03/01/2013
Last updated
03/01/2013
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