Healthcare Provider Details

I. General information

NPI: 1225950793
Provider Name (Legal Business Name): GO BEHAVIORAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 FRESNO ST
FRESNO CA
93721-1439
US

IV. Provider business mailing address

22161 ROAD 211
FRIANT CA
93626-9766
US

V. Phone/Fax

Practice location:
  • Phone: 0
  • Fax:
Mailing address:
  • Phone: 559-908-7325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: EVAN NOAH YORK
Title or Position: BEHAVIOR TECHNICIAN
Credential:
Phone: 559-908-7325