California Department Of Corrections &rehabilitation | |
21633 Avenue 24 Chowchilla CA 93610-0099 | |
(559) 665-6100 | |
Not Available |
Full Name | California Department Of Corrections &rehabilitation |
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Speciality | Clinic/center - Rural Health |
Location | 21633 Avenue 24, Chowchilla, California |
Authorized Official Name and Position | Barbara L. Woodward (NURSE PRACTITIONER) |
Authorized Official Contact | 5596656100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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California Department Of Corrections &rehabilitation 21633 Avenue 24 Chowchilla CA 93610-0099 Ph: (559) 665-6100 | California Department Of Corrections &rehabilitation 21633 Avenue 24 Chowchilla CA 93610-0099 Ph: (559) 665-6100 |
NPI Number | 1073710398 |
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Provider Enumeration Date | 06/29/2007 |
Last Update Date | 02/05/2009 |
Identifier | Type | State | Issuer |
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1073710398 | NPI | - | NPPES |
8004039 | Other | CA | STATE ID # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | RN#452501 N.P.#8290 (California) | Primary |
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