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CH09039AQ CLINICA SIERRA VISTA (Terminated)
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Main Details
Name
CLINICA SIERRA VISTA
Subdivision Name
SOUTH CENTRAL BAKERSFIELD BHC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017817
340B ID
CH09039AQ
Grant Number
H80CS00540
Additional Details
Current Program Status
Terminated
Registration Date
4/8/2014
Participating Start Date
7/1/2014
Participating Approval Date
5/2/2014
Last Recertification Date
2/20/2020
Termination Date
Termination Reason
4/1/2021
Other
Contacts
Authorizing Official
Clinica Sierra Vista
Stacy Lynn Ferreira, CEO
(661) 635-3050
Primary Contact
Clinica Sierra Vista
Nancy Banuelos, Deputy CEO
(661) 635-3050
Addresses
Street Address
3105 Wilson Road
Bakersfield, CA 93304-0000
Billing Address
Clinica Sierra Vista
1430 Truxtun Ave #400
Bakersfield, CA 93301
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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