CLINICA SIERRA VISTA (NPI# 1811011679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811011679 |
| Entity Type | Organization |
| Organization Name | CLINICA SIERRA VISTA |
| Other Organization Name | FRAZIER MOUNTAIN COMMUNITY HEALTH CENTER - CDP/EWC |
| Practice Address |
704 Lebec Road Lebec CA 93243 |
| Mailing Address |
Po Box 1559 1430 Truxtun Avenue Ste. 400 Bakersfield CA 93302-1559 |
| Practice Telephone | 6612485250 |
| Practice Fax Number | 6612485279 |
| Mailing Telephone | 6616353050 |
| Mailing Fax Number | 6618691503 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-09-15 |
| Authorized Official Name | KELLY LUTZ (REVENUE CYCLE MANAGER) |
| Authorized Official Telephone | 5594575835 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
120000199 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICAL SPECIALTY | BCP12040F | 01 |
| CA | MEDICAL SPECIALTY | FHC12040F | 01 |
| Other Name | Type Code |
|---|---|
| Frazier Mountain Community Health Center | Doing Business As Name - Organization |
| Frazier Mountain Community Health Center - CDP/EWC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740740331 | Clinica Sierra Vista | Clinic/Center | 3451 W Shaw Ave Ste 105, Fresno, CA 93711-3242 | 2019-03-21 |
| 1336544790 | Clinica Sierra Vista | Clinic/Center | 705 S Union Ave, Bakersfield, CA 93307-3635 | 2014-10-28 |
| 1184972374 | Clinica Sierra Vista | Clinic/Center | 828 High St Ste A, Delano, CA 93215-2960 | 2012-08-21 |
| 1235486648 | Clinica Sierra Vista | Clinic/Center | 234 Baker St Ste 1&2, Bakersfield, CA 93305-5856 | 2012-08-06 |
| 1033486048 | Clinica Sierra Vista | Clinic/Center | 3645 W Shaw Ave Ste 101, Fresno, CA 93711-3206 | 2011-11-18 |
| 1326327693 | Clinica Sierra Vista | Counselor | 700 Falcon Way, Lebec, CA 93243 | 2011-08-04 |
| 1417236787 | Clinica Sierra Vista | Counselor | 800 Browning Rd, Delano, CA 93215-9494 | 2011-08-04 |
| 1144509415 | Clinica Sierra Vista | Counselor | 1331 Cecil Ave # 6, Delano, CA 93215-1418 | 2011-08-04 |
| 1528347887 | Clinica Sierra Vista | Counselor | 1927 Randolph St Rm 1, Delano, CA 93215-1526 | 2011-08-04 |
| 1629356522 | Clinica Sierra Vista | Counselor | 1401 Hiett Ave, Delano, CA 93215 | 2011-07-26 |
| Street Address |
704 LEBEC ROAD |
| City | LEBEC |
| State | CA |
| Zip Code | 93243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720048168 | Brent Alexander Burket | Family Medicine | 704 Lebec Road, Lebec, CA 93243 | 2006-03-27 |
| 1215061528 | Clinca Sierra Vista | Clinic/Center | 704 Lebec Road, Lebec, CA 93243 | 2007-03-16 |
| 1235249012 | John Grant | Family Medicine | 704 Lebec Road, Lebec, CA 93243 | 2006-08-30 |
| 1518904903 | Jennifer Thoene | Family Medicine | 704 Lebec Road, Lebec, CA 93243 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225383045 | Diane Tatjana Cosko | Veterinarian | 837 Lebec Rd., Lebec, CA 93243 | 2012-07-18 |
| 1326327693 | Clinica Sierra Vista | Counselor | 700 Falcon Way, Lebec, CA 93243 | 2011-08-04 |
| 1821119595 | Mariaannabella Rusen Porazik | Dentist | 2045 Lebec Rd., Lebec, CA 93243 | 2007-04-02 |
| 1467506444 | Peter Porazik | Dentist | 2045 Lebec Road, Lebec, CA 93243 | 2007-01-23 |
| 1457353831 | Clinca Sierra Vista | Clinic/Center | 704 Lebec Rd, Lebec, CA 93243 | 2005-08-15 |
| 1376790527 | Robert Martinez | Family Medicine | 704 Lebec Rd, Lebec, CA 93243 | 2008-08-19 |
| 1174543912 | Xtreme Medical Inc | Durable Medical Equipment & Medical Supplies | 49744 Gorman Post Rd, 4, Gorman, CA 93243-9701 | 2006-07-21 |
| 1952755738 | El Tejon Unified School District | Local Education Agency (LEA) | 4337 Lebec Rd, Lebec, CA 93243-9705 | 2016-04-19 |
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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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.