Healthcare Provider Details

I. General information

NPI: 1760307565
Provider Name (Legal Business Name): CHRISTOPHER DANIEL PATRICK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 E BELMONT AVE
FRESNO CA
93701-1502
US

IV. Provider business mailing address

611 E BELMONT AVE
FRESNO CA
93701-1502
US

V. Phone/Fax

Practice location:
  • Phone: 559-237-3420
  • Fax: 559-485-7244
Mailing address:
  • Phone: 559-237-3420
  • Fax: 559-485-7244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number26516
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: