Department of State Hospitals

NPI #1124078704 in Coalinga, California

Provider Information

NPI Number
1124078704
Entity Type
Organization
Organization Name
Department of State Hospitals
Primary Specialty
Psychiatric Hospital
Enumeration Date
May 12, 2006
Last Updated
Oct 19, 2021

Practice Location

Address
24511 W JAYNE AVE
ZIP Code
93210-9503
Phone
(559) 935-4300

Authorized Official

Name
GEORGE MAYNARD
Title
ADMINISTRATIVE DEPUTY DIRECTOR
Phone
(916) 651-3238

Specialties & Taxonomy Codes

Specialty
General Acute Care Hospital
Intermediate Care Facility, Mental Illness
Pharmacy
Pharmacy - Long Term Care PharmacyLong Term Care Pharmacy
Psychiatric Hospital

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Organizations

Provider Name
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