Provider Demographics
NPI:1114637873
Name:MADERA COUNTY DEPARTMENT OF PUBLIC HEALTH
Entity Type:Organization
Organization Name:MADERA COUNTY DEPARTMENT OF PUBLIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY PH DIRECTOR - OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-675-7893
Mailing Address - Street 1:1604 SUNRISE AVE
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93638-4926
Mailing Address - Country:US
Mailing Address - Phone:559-675-7893
Mailing Address - Fax:
Practice Address - Street 1:1604 SUNRISE AVE
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-4926
Practice Address - Country:US
Practice Address - Phone:559-675-7893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF MADERA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty