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CLINICA SIERRA VISTA NPI 1457353831


NPI Information

NPI: 1457353831
Provider Name: CLINICA SIERRA VISTA

Doing Business As: FRAZIER MOUNTAIN COMMUNITY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 05D0585208

Address:
704 LEBEC RD
LEBEC, CA
ZIP 93243
Phone: (661) 248-5250
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CLINICA SIERRA VISTA is a federally qualified health center (fqhc) clinic center in Lebec, CA. CLINICA SIERRA VISTA NPI is 1457353831. The provider is registered as an organization entity type.
The provider Is Doing Business As Frazier Mountain Community Health Center.

The provider's business location address is:

704 LEBEC RD
LEBEC, CA
ZIP 93243
Phone: (661) 248-5250
Fax: (661) 248-5279

The provider's authorized official is Maria Nancy Banuelos .
The authorized official title is Deputy Ceo and has the following contact phone number (661) 635-3050.

The CLIA number assigned to this NPI record is 05D0585208 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/15/2005 and was last updated on 3/29/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)120000199CALIFORNIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1HAP12040FOTHERCALIFORNIAFAMILY PACT
212040FMEDICAIDCALIFORNIA
3BCP12040FOTHERCALIFORNIACDP
4ZZZ65152ZOTHERCALIFORNIABLUE SHIELD PIN

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: 11/14/2023

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