Organization
SIERRA CONSERVATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD HALLIBURTON PSY.D. (CLINICAL PSYCHOLOGIST)
(209) 984-5291
Entity
Organization
Contact information
Practice address
5100 OBYRNES FERRY RD, JAMESTOWN, CA 95327-9102
(209) 984-5291
Mailing address
5100 OBYRNES FERRY RD, JAMESTOWN, CA 95327-9102
(209) 984-5291
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
PSY 20801
CA
Other
Enumeration date
02/24/2017
Last updated
02/24/2017
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