Healthcare Provider Details
I. General information
NPI: 1437347721
Provider Name (Legal Business Name): THE FRESNO CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2007
Last Update Date: 08/23/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4855 E CESAR CHAVEZ
FRESNO CA
93727-3811
US
IV. Provider business mailing address
1725 N FINE AVE
FRESNO CA
93727-1616
US
V. Phone/Fax
- Phone: 559-255-8395
- Fax: 559-255-1656
- Phone: 559-255-8395
- Fax: 559-255-1656
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251X00000X |
| Taxonomy | Supports Brokerage Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAO
TOMMY
YANG
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 559-255-8395