NPIMap

Organization Active NPI

Sierra Meadows Behavioral Health

  • Psychiatric Residential Treatment Facility
  • Clovis, CA
National Provider Identifier
1972185031
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
SIERRA MEADOWS BEHAVIORAL HEALTH
Practice address
1747 N Jasmine Ave
Clovis, CA 93619-4282
Phone
(559) 593-9801
NPI assigned
Apr 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Authorized official

Name
Matthew Thomas Tatum
Title
Ceo
Phone
(559) 326-7775

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X Primary

Addresses

Primary practice location

1747 N Jasmine Ave
Clovis, CA 93619-4282

Mailing address

1781 E Fir Ave Ste 102
Fresno, CA 93720-3865

Other identifiers 1

IdentifierTypeStateIssuer
7209089OtherCADHCS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2225371Sierra Meadows Behavioral Health1747 N Jasmine Ave, Clovis, CA 93619Certificate of waiverMay 19, 2027

National Provider Directory

National Provider Directory
Tax ID family
Sierra Meadows Behavioral Health7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629331200000",
    "number": "1972185031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1781 E FIR AVE STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 N JASMINE AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936194282",
            "telephone_number": "559-593-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA MEADOWS BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A",
        "authorized_official_last_name": "TATUM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-326-7775"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHCS",
            "identifier": "7209089",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.