Healthcare Provider Details

I. General information

NPI: 1689736092
Provider Name (Legal Business Name): COUNTY DEPARTMENT OF BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4441 E KINGS CANYON RD
FRESNO CA
93702-3604
US

IV. Provider business mailing address

4441 E KINGS CANYON RD
FRESNO CA
93702-3604
US

V. Phone/Fax

Practice location:
  • Phone: 559-453-4099
  • Fax: 559-453-8450
Mailing address:
  • Phone: 559-453-4099
  • Fax: 559-453-8450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MS. GIANG NGUYEN
Title or Position: DIRECTOR
Credential: R.N.
Phone: 559-453-4099