Healthcare Provider Details
I. General information
NPI: 1528121001
Provider Name (Legal Business Name): COUNTY OF FRESNO, DEPT OF BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/18/2006
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
- Phone: 559-453-4099
- Fax:
- Phone: 559-453-4099
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GIANG
NGUYEN
Title or Position: DIRECTOR
Credential:
Phone: 559-453-4099