NPIMap

Organization Active NPI

County of Tulare

Doing business as Porterville Adult Mental Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Porterville, CA
National Provider Identifier
1396779013
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
COUNTY OF TULARE
Doing business as
Porterville Adult Mental Health Clinic
Practice address
1055 W Henderson Ave
Porterville, CA 93257-1490
Phone
(559) 788-1200
Fax
(559) 782-3910
NPI assigned
Jul 10, 2006
Last updated
Jul 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Natalie Bolin
Title
Director of Mental Health
Phone
(559) 624-7445

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1055 W Henderson Ave
Porterville, CA 93257-1490

Mailing address

5957 S Mooney Blvd
Visalia, CA 93277-9394
Phone (559) 624-8000

Other identifiers 1

IdentifierTypeStateIssuer
000005429MedicaidCA

Other names 1

  • Porterville Adult Mental Health Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000821 CA Part B Supplier - Clinic/Group Practice 1456264555 Receives reassigned benefits from 89 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Visalia, CA; Tulare, CA; Porterville, CA; Farmersville, CA

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Co of Tulane23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

1055 W Henderson Ave
Porterville, CA 93257
Phone (559) 788-1200

520 E Tulare Ave
Visalia, CA 93292

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1396779013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5957 S MOONEY BLVD",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932779394",
            "telephone_number": "559-624-8000",
            "fax_number": "559-737-4697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 W HENDERSON AVE",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932571490",
            "telephone_number": "559-788-1200",
            "fax_number": "559-782-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF TULARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "BOLIN",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_title_or_position": "DIRECTOR OF MENTAL HEALTH",
        "authorized_official_telephone_number": "559-624-7445"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000005429",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Porterville Adult Mental Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Porterville Adult Mental Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Porterville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.