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NPI Code Detail

MEDICARE: FRESNO YOUTH ADVOCATES

MEDICARE: FRESNO YOUTH ADVOCATES
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
1251V00000XVoluntary or Charitable AgencyCA

General Provider Information

NPI Number : 1528190402
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRESNO YOUTH ADVOCATES
Provider Business Mailing Address
First Line : 2560 W SHAW LN
Second Line : SUITE 101
City : FRESNO
State : CA
Zip : 93711-2777
Country : US
Telephone Number : 559-431-0580
Fax Number :
Provider Business Practice Location Address
First Line : 2560 W SHAW LN
Second Line : SUITE 101
City : FRESNO
State : CA
Zip : 93711-2777
Country : US
Telephone Number : 559-431-0580
Fax Number :
Authorized Official
Title or Position : THERAPIST
Name : MR. MYRON KEITH DOWNING
Credential : LMFT 19396
Telephone Number : 559-431-0500
Provider Enumeration Date : 03/09/2007
Last Update Date : 08/22/2020

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Directions to “FRESNO YOUTH ADVOCATES ” Practice Location

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