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NPI Code Detail

MEDICARE: COUNTY OF FRESNO

MEDICARE: COUNTY OF FRESNO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1770538001
Entity Type Code : Organization
Provider Name (Legal Business Name) : COUNTY OF FRESNO
Provider Business Mailing Address
First Line : 1925 E DAKOTA AVE
Second Line :
City : FRESNO
State : CA
Zip : 93726-4821
Country : US
Telephone Number : 559-600-9058
Fax Number :
Provider Business Practice Location Address
First Line : 1925 E DAKOTA AVE
Second Line :
City : FRESNO
State : CA
Zip : 93726-4821
Country : US
Telephone Number : 559-600-9058
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : SUSAN L. HOLT
Credential : LMFT
Telephone Number : 559-600-9058
Provider Enumeration Date : 05/24/2006
Last Update Date : 05/08/2024

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Directions to “COUNTY OF FRESNO ” Practice Location

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