Healthcare Provider Details

I. General information

NPI: 1689809097
Provider Name (Legal Business Name): FRESNO COUNTY BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2009
Last Update Date: 05/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 BARBOSA ST.
MENDOTA CA
93640
US

IV. Provider business mailing address

5108 E CLINTON WAY
FRESNO CA
93727-2043
US

V. Phone/Fax

Practice location:
  • Phone: 559-846-7500
  • Fax:
Mailing address:
  • Phone: 559-452-3470
  • 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 State

VIII. Authorized Official

Name: GIANG NGUYEN
Title or Position: MENTAL HEALTH DIRECTOR
Credential: RN
Phone: 559-452-3463