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General NPI Number Information
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NPI Number | 1992504930
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Entity Type | Organization
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Legal Business Name | FRONTLINE RESILIENCY SUPPORT TEAM PSYCHOLOGY
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 5287 W CALIMYRNA AVE
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City | FRESNO
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State | CA
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Zip | 93722-3333
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Country | US
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Telephone | 559-706-8630
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Fax |
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Provider Business Mailing Address
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Address Line | 6737 N MILBURN AVE STE 160 #26
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City | FRESNO
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State | CA
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Zip | 93722
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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 | PRESIDENT
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Name | DR. VANESSA NASH
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Credential |
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Telephone | 559-706-8630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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