Organization
COUNTY OF TULARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHERYL L DUERKSEN (AGENCY DIRECTOR)
(559) 624-8000
Entity
Organization
Contact information
Practice address
5957 S MOONEY BLVD, VISALIA, CA 93277-9394
(559) 624-8000
(559) 737-4697
Mailing address
5957 S MOONEY BLVD, VISALIA, CA 93277-9394
(559) 624-8000
(559) 737-4697
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0001200
—
CA
Enumeration date
01/31/2007
Last updated
05/06/2013
Update your record
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