Provider Demographics
NPI:1942890132
Name:CENTRAL CALIFORNIA HEALTH CENTERS
Entity Type:Organization
Organization Name:CENTRAL CALIFORNIA HEALTH CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:YEAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-327-4647
Mailing Address - Street 1:300 OLD RIVER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9506
Mailing Address - Country:US
Mailing Address - Phone:661-664-2319
Mailing Address - Fax:
Practice Address - Street 1:9500 STOCKDALE HWY STE 109
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3621
Practice Address - Country:US
Practice Address - Phone:661-664-4455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL CALIFORNIA HEALTH CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center