Healthcare Provider Details

I. General information

NPI: 1912430240
Provider Name (Legal Business Name): RESOURCES FOR INDEPENDENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2017
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3636 N 1ST ST STE 101
FRESNO CA
93726-6818
US

IV. Provider business mailing address

3636 N 1ST ST STE 101
FRESNO CA
93726-6818
US

V. Phone/Fax

Practice location:
  • Phone: 559-221-2330
  • Fax:
Mailing address:
  • Phone: 559-221-2330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY21346
License Number StateCA

VIII. Authorized Official

Name: TANESHA MORRIS
Title or Position: PROGRAM MANAGER
Credential:
Phone: 559-396-0560