EMINENCE HEALTHCARE, INC. (NPI# 1790174837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790174837 |
| Entity Type | Organization |
| Organization Name | EMINENCE HEALTHCARE, INC. |
| Practice Address |
33087 Road 228 Room 23 North Fork CA 93643-9695 |
| Mailing Address |
Po Box 27707 Fresno CA 93729-7707 |
| Practice Telephone | 5598772215 |
| Mailing Telephone | 5592218100 |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2015-07-01 |
| Authorized Official Name | JUAN GARZA II (COO/PROGRAM DIRECTOR) |
| Authorized Official Telephone | 5592218100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417346370 | Eminence Healthcare, Inc. | Clinic/Center | 33030 Road 228, Room 5, North Fork, CA 93643-9694 | 2015-01-15 |
| 1770972705 | Eminence Healthcare, Inc. | Clinic/Center | 46655 Road 200, O'neals, CA 93645-0210 | 2015-01-14 |
| 1356730444 | Eminence Healthcare, Inc. | Clinic/Center | 45077 Road 200, Room 305, O'neals, CA 93645-0186 | 2015-01-13 |
| 1760615728 | Eminence Healthcare, Inc. | Clinic/Center | 305 E. C Street, Dixon, CA 95620-3000 | 2009-08-25 |
| 1508099565 | Eminence Healthcare, Inc. | Clinic/Center | 200 N. Lincoln Street, Dixon, CA 95620-3209 | 2009-08-25 |
| 1336371491 | Eminence Healthcare, Inc. | Clinic/Center | 555 College Way, Dixon, CA 95620-9301 | 2009-08-21 |
| 1083866412 | Eminence Healthcare, Inc. | Clinic/Center | 33326 Lodge Rd, Room 22, Tollhouse, CA 93667-9644 | 2008-10-16 |
| 1487805586 | Eminence Healthcare, Inc. | Clinic/Center | 33280 Lodge Rd, Room 4, Tollhouse, CA 93667-9643 | 2008-10-07 |
| 1043469539 | Eminence Healthcare, Inc. | Clinic/Center | 6240 W Palo Alto Ave, Rm 201, 301, 801-805, Fresno, CA 93722-2001 | 2008-09-09 |
| 1942479092 | Eminence Healthcare, Inc. | Clinic/Center | 599 Fifth Street, Mcfarland, CA 93250 | 2008-02-22 |
| Street Address |
33087 ROAD 228 ROOM 23 |
| City | NORTH FORK |
| State | CA |
| Zip Code | 93643-9695 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215287123 | Cindy Lee Bastianon | Technician | 59462 Rd. 225, Spc 1, North Fork, CA 93643 | 2012-09-18 |
| 1477565356 | Aaron Christopher Kissel | Family Medicine | 32938 Road 222, Suite 2, North Fork, CA 93643-9562 | 2006-08-12 |
| 1932329091 | Central Valley Indian Health, Inc | Clinic/Center | 32938 Road 222, Suite 2, North Fork, CA 93643-9562 | 2007-04-30 |
| 1871742932 | Edmund H Fey | Dentist | 56928 Buckhorn Ct, North Fork, CA 93643-9572 | 2008-09-14 |
| 1912148099 | Yosemite Connections | Substance Abuse Rehabilitation Facility | 53022 Pine Hill Ln, North Fork, CA 93643-9682 | 2009-03-18 |
| 1417346370 | Eminence Healthcare, Inc. | Clinic/Center | 33030 Road 228, Room 5, North Fork, CA 93643-9694 | 2015-01-15 |
| 1407971427 | Ronald D Brix | Emergency Medicine | 53673 Moic Dr, North Fork, CA 93643-9794 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417346370 | Eminence Healthcare, Inc. | Clinic/Center | 33030 Road 228, Room 5, North Fork, CA 93643-9694 | 2015-01-15 |
| 1215287123 | Cindy Lee Bastianon | Technician | 59462 Rd. 225, Spc 1, North Fork, CA 93643 | 2012-09-18 |
| 1912148099 | Yosemite Connections | Substance Abuse Rehabilitation Facility | 53022 Pine Hill Ln, North Fork, CA 93643-9682 | 2009-03-18 |
| 1871742932 | Edmund H Fey | Dentist | 56928 Buckhorn Ct, North Fork, CA 93643-9572 | 2008-09-14 |
| 1407971427 | Ronald D Brix | Emergency Medicine | 53673 Moic Dr, North Fork, CA 93643-9794 | 2007-03-20 |
| 1477565356 | Aaron Christopher Kissel | Family Medicine | 32938 Road 222, Suite 2, North Fork, CA 93643-9562 | 2006-08-12 |
| 1932329091 | Central Valley Indian Health, Inc | Clinic/Center | 32938 Road 222, Suite 2, North Fork, CA 93643-9562 | 2007-04-30 |
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417346370 | Eminence Healthcare, Inc. | Clinic/Center | 33030 Road 228, Room 5, North Fork, CA 93643-9694 | 2015-01-15 |
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| Find all providers with the same taxonomy | ||||
| City | NORTH FORK |
| Zip Code | 93643 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.