Healthcare Provider Details

I. General information

NPI: 1669302022
Provider Name (Legal Business Name): BREATH OF EVOLUTION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 FULTON ST
FRESNO CA
93721-1653
US

IV. Provider business mailing address

1600 FULTON ST # 3
FRESNO CA
93721-1653
US

V. Phone/Fax

Practice location:
  • Phone: 805-712-4860
  • Fax:
Mailing address:
  • Phone: 805-712-4860
  • 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: ROGER BROWN
Title or Position: FOUNDER / CEO
Credential:
Phone: 805-712-4860