Healthcare Provider Details

I. General information

NPI: 1104758333
Provider Name (Legal Business Name): CALIFORNIA COMMUNITY SERVICES AND REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 W STROTHER AVE
FRESNO CA
93706-2936
US

IV. Provider business mailing address

PO BOX 41
VACAVILLE CA
95696-0041
US

V. Phone/Fax

Practice location:
  • Phone: 707-549-8747
  • Fax:
Mailing address:
  • Phone: 707-549-8747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CARTER LEE ANDERSON JR.
Title or Position: FOUNDER/PRESIDENT
Credential:
Phone: 707-592-6281