Healthcare Provider Details

I. General information

NPI: 1881335701
Provider Name (Legal Business Name): WEST FRESNO HEALTH CARE COALITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 05/15/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 VAN NESS AVE STE 201
FRESNO CA
93721-2931
US

IV. Provider business mailing address

700 VAN NESS AVE STE 201
FRESNO CA
93721-2931
US

V. Phone/Fax

Practice location:
  • Phone: 559-374-5750
  • Fax:
Mailing address:
  • Phone: 559-374-5750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. YOLANDA SUZETTE RANDLES
Title or Position: EXECUTIVE DIRECTOR
Credential: MPH
Phone: 559-374-5750