Healthcare Provider Details

I. General information

NPI: 1396804191
Provider Name (Legal Business Name): COUNTY OF FRESNO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2006
Last Update Date: 04/16/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4452 E CESAR CHAVEZ BLVD
FRESNO CA
93702-9370
US

IV. Provider business mailing address

4452 E KINGS CANYON RD
FRESNO CA
93702-9370
US

V. Phone/Fax

Practice location:
  • Phone: 559-600-9180
  • Fax: 559-600-7644
Mailing address:
  • Phone: 559-600-9180
  • Fax: 559-600-7644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number StateCA

VIII. Authorized Official

Name: SUSAN L HOLT
Title or Position: DIRECTOR OF BEHAVIORAL HEALTH/PUBLI
Credential: LMFT
Phone: 559-600-9058