Healthcare Provider Details

I. General information

NPI: 1881746717
Provider Name (Legal Business Name): FRESNO COUNTY NORTH FRESNO REGIONAL MH CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 E MINARETS AVE SUITE 1
PINEDALE CA
93650-1215
US

IV. Provider business mailing address

28 E MINARETS AVE SUITE 1
PINEDALE CA
93650-1215
US

V. Phone/Fax

Practice location:
  • Phone: 559-436-0482
  • Fax:
Mailing address:
  • Phone: 559-436-0482
  • 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 StateCA

VIII. Authorized Official

Name: MRS. GIANG T NGUYEN
Title or Position: DIRECTOR, FRESNO CO MENTAL HEALTH
Credential:
Phone: 559-253-9180