Healthcare Provider Details

I. General information

NPI: 1093912115
Provider Name (Legal Business Name): FRESNO COUNTY COMMUNITY OUTREACH FOR PSYCHIATRIC EMERGENCIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3147 N MILLBROOK AVE
FRESNO CA
93703-1425
US

IV. Provider business mailing address

3147 N MILLBROOK AVE
FRESNO CA
93703-1425
US

V. Phone/Fax

Practice location:
  • Phone: 559-453-4309
  • Fax:
Mailing address:
  • Phone: 559-453-4309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. DONNA SUE TAYLOR
Title or Position: INTERIM DEPUTY DIRECTOR
Credential: R.N.
Phone: 559-453-5798