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General NPI Number Information
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NPI Number | 1639482557
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Entity Type | Organization
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Legal Business Name | GOLDEN STATE FAMILY SERVICES, INC.
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Dates
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Enumeration Date | 07/20/2010
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Last Update Date | 07/20/2010
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Provider Practice Location Address
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Address Line | 4285 N VALENTINE AVE
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City | FRESNO
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State | CA
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Zip | 93722-4148
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Country | US
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Telephone | 559-241-0955
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Fax | 559-241-0969
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Provider Business Mailing Address
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Address Line | PO BOX 130
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City | KINGSBURG
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State | CA
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Zip | 93631-0130
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/CEO
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Name | MICKI D. PRINS
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Credential |
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Telephone | 559-271-7769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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