MEDICARE: FRESNO NEW CONNECTION, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	100027AN	CA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1265507297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRESNO NEW CONNECTION, INC.

Provider Business Mailing Address
First Line	:	4411 N. CEDAR AVE. #108
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93726
Country	:	US
Telephone Number	:	559-248-1548
Fax Number	:	559-248-1530

Provider Business Practice Location Address
First Line	:	4411 N. CEDAR AVE. #108
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93726
Country	:	US
Telephone Number	:	559-248-1548
Fax Number	:	559-248-1530

Authorized Official
Title or Position	:	LPHA
Name	:	CYNTHIA ROBINSON
Credential	:
Telephone Number	:	559-248-1548

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	04/09/2026

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