FAMILY HEALTHCARE NETWORK NPI 1164517744

NPI Information

NPI: 1164517744
Provider Name: FAMILY HEALTHCARE NETWORK
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 05D0585494

Address:
201 E LAKEVIEW AVE
WOODLAKE, CA
ZIP 93286
Phone: (559) 564-0100
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FAMILY HEALTHCARE NETWORK is a federally qualified health center (fqhc) clinic center in Woodlake, CA. FAMILY HEALTHCARE NETWORK NPI is 1164517744. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

201 E LAKEVIEW AVE
WOODLAKE, CA
ZIP 93286-301
Phone: (559) 564-0100
Fax: (559) 564-2285

The provider's authorized official is Kerry Hydash .
The authorized official title is President Ceo and has the following contact phone number (559) 737-4731.

The CLIA number assigned to this NPI record is 05D0585494 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/3/2006 and was last updated on 10/27/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171M00000X	Case Manager/Care Coordinator				No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	120000643	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	FHC70851F	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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