Organization
FOCUS-N
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHEA GUMBS M.A (VICE PRESIDENT)
(209) 607-1018
Entity
Organization
Contact information
Practice address
1557 SOPHIE LN, ESCALON, CA 95320-8406
(209) 607-1018
Mailing address
PO BOX 19189, OAKLAND, CA 94619-0189
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
07/07/2021
Last updated
07/07/2021
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