=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437817129
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FIRST STEPS ADDICTION COUNSELING AND PSYCHIATRY PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/30/2021
-----------------------------------------------------
Last Update Date | 08/10/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8441 N MILLBROOK AVE
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93720-2199
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-558-8903
-----------------------------------------------------
Fax | 559-593-7638
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8441 N MILLBROOK AVE STE 102
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93720-2199
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-558-8903
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | JOSHUA BEAUCHAINE
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 949-584-5957
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------