Provider Demographics
NPI:1902493448
Name:JOHN C FREMONT HEALTHCARE DISTRICT
Entity Type:Organization
Organization Name:JOHN C FREMONT HEALTHCARE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL STAFF COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNE-MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEELEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-966-3631
Mailing Address - Street 1:PO BOX 216
Mailing Address - Street 2:
Mailing Address - City:MARIPOSA
Mailing Address - State:CA
Mailing Address - Zip Code:95338-0216
Mailing Address - Country:US
Mailing Address - Phone:209-966-3631
Mailing Address - Fax:209-672-6140
Practice Address - Street 1:5072 BULLION ST
Practice Address - Street 2:
Practice Address - City:MARIPOSA
Practice Address - State:CA
Practice Address - Zip Code:95338-2416
Practice Address - Country:US
Practice Address - Phone:209-742-7272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy