Provider Demographics
NPI:1447683826
Name:CHILDRENS HOSPITAL CENTRAL CALIFORNIA
Entity type:Organization
Organization Name:CHILDRENS HOSPITAL CENTRAL CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSALINDA
Authorized Official - Middle Name:CONTRERAS
Authorized Official - Last Name:MOECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-307-7466
Mailing Address - Street 1:4080 N WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-4142
Mailing Address - Country:US
Mailing Address - Phone:559-307-7466
Mailing Address - Fax:
Practice Address - Street 1:4080 N WILSON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-4142
Practice Address - Country:US
Practice Address - Phone:559-307-7466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren