Department of State Hospital Coalinga
Organization Active NPI Prison Health Clinic/Center · Coalinga, CA
NPI 1780181222 · NPPES record last updated Apr 11, 2018
Key facts
- NPI
- 1780181222
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Prison Health Clinic/Center 261QP2400X
- Legal business name
- DEPARTMENT OF STATE HOSPITAL COALINGA
- Practice address
- 24511 W Jayne Ave
Coalinga, CA 93210-9516 - Phone
- (559) 935-4300
- NPI assigned
- Apr 11, 2018
- Organization subpart
- No
Authorized official
- Name
- Dr. Jeoung Park
- Title
- Clinical Psychologist
- Phone
- (559) 934-3201
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prison Health Clinic/Center | 261QP2400X | Yes |
Addresses
Primary practice location
24511 W Jayne Ave
Coalinga, CA 93210-9516
Mailing address
24511 W Jayne Ave
Coalinga, CA 93210-9516
Phone (559) 935-4300
Other names
- Coalinga State Hospital
Other providers in Coalinga, CA
- Trucmy Dang
- Jeffrey Jay Davis
- Richard C Davis Jr.
- Frieda Dehnavifar
- Department of State Hospital Coalinga
- Department of State Hospitals
- Tracy Dern
- Deleon Devaughn
- David Dinishak
- Lamberto Samodio Domingo
All providers in Coalinga, CA · Prison Health Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.