Healthcare Provider Details

I. General information

NPI: 1285219600
Provider Name (Legal Business Name): FRESNO COUNTY SUPERINTENDENT OF SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2021
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4939 E YALE AVE
FRESNO CA
93727-1523
US

IV. Provider business mailing address

1111 VAN NESS AVE
FRESNO CA
93721-2002
US

V. Phone/Fax

Practice location:
  • Phone: 559-443-4800
  • Fax:
Mailing address:
  • Phone: 559-443-4800
  • 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 StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: YVETTE GARCIA
Title or Position: CLINICAL DIRECTOR
Credential: LMFT
Phone: 559-443-4800