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General NPI Number Information
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NPI Number | 1336277979
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Entity Type | Organization
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Legal Business Name | FRESNO COUNTY CHILDREN'S CRISIS ASSESSMENT INTERVENTION &RESOLUTION
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3147 N MILLBROOK AVE
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City | FRESNO
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State | CA
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Zip | 93703-1425
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Country | US
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Telephone | 559-453-3860
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Fax |
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Provider Business Mailing Address
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Address Line | 3133 N MILLBROOK AVE
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City | FRESNO
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State | CA
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Zip | 93703-1425
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Country | US
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Telephone | 559-453-8918
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Fax |
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Authorized Official
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Title or Position | INTERIM DEPUTY DIRECTOR
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Name | MRS. DONNA SUE TAYLOR
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Credential | R.N.
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Telephone | 559-453-5798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 0000010AP
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License Number State | CA
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