1437151800 NPI number — CLINICA SIERRA VISTA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437151800 NPI number — CLINICA SIERRA VISTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLINICA SIERRA VISTA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437151800
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1559
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93302-1559
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-635-3050
Provider Business Mailing Address Fax Number:
661-732-3064

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
67 EVANS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOFFORD HEIGHTS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93285-9640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-376-2276
Provider Business Practice Location Address Fax Number:
760-376-4801
Provider Enumeration Date:
08/15/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MEAVE
Authorized Official First Name:
OLGA
Authorized Official Middle Name:
Authorized Official Title or Position:
INTERIM CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
661-635-3050

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X , with the licence number:  120000201 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: HAP03896F . This is a "SOFP" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 03896F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: BCP03896F . This is a "CDP" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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