Healthcare Provider Details

I. General information

NPI: 1235267535
Provider Name (Legal Business Name): FRESNO COUNTY EMPLOYMENT SVC PROGRAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 S CEDAR AVE
FRESNO CA
93702-2908
US

IV. Provider business mailing address

4441 E KINGS CANYON RD
FRESNO CA
93702-3604
US

V. Phone/Fax

Practice location:
  • Phone: 559-453-8300
  • Fax:
Mailing address:
  • Phone: 559-253-9180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateCA

VIII. Authorized Official

Name: GIANG T NGUYEN
Title or Position: DIRECTOR, FRESNO CO MENTAL HEALTH
Credential:
Phone: 559-253-9180