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General NPI Number Information
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NPI Number | 1083936785
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Entity Type | Organization
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Legal Business Name | FRESNO COUNTY
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 142 E CESAR CHAVEZ BLVD
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City | FRESNO
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State | CA
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Zip | 93706-3642
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Country | US
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Telephone | 559-453-8270
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Fax | 559-453-3355
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Provider Business Mailing Address
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Address Line | 142 E CESAR CHAVEZ BLVD
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City | FRESNO
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State | CA
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Zip | 93706-3642
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Country | US
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Telephone | 559-453-8270
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Fax | 559-453-3355
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Authorized Official
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Title or Position | DIRECTOR
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Name | SUSAN LEIGH HOLT
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Credential | LMFT
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Telephone | 559-600-9058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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