Healthcare Provider Details

I. General information

NPI: 1487709895
Provider Name (Legal Business Name): FAMILIESFIRST INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7080 N MARKS AVE 104
FRESNO CA
93711-0288
US

IV. Provider business mailing address

7080 N MARKS AVE 104
FRESNO CA
93711-0288
US

V. Phone/Fax

Practice location:
  • Phone: 559-248-8550
  • Fax: 559-248-8555
Mailing address:
  • Phone: 559-248-8550
  • Fax: 559-248-8555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License NumberIMF41053
License Number StateCA

VIII. Authorized Official

Name: MRS. LISA MICHELLE MCCARTER
Title or Position: MENTAL HEALTH CLINICIAN
Credential: MFT INTERN
Phone: 559-907-6592