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NPI Code Detail

MEDICARE: OMEGA MENTAL HEALTH

MEDICARE: OMEGA MENTAL HEALTH
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
1106H00000XMarriage & Family Therapist
2103T00000XPsychologist

General Provider Information

NPI Number : 1780184606
Entity Type Code : Organization
Provider Name (Legal Business Name) : OMEGA MENTAL HEALTH
Provider Business Mailing Address
First Line : 2549 W SHAW AVE
Second Line :
City : FRESNO
State : CA
Zip : 93711-3308
Country : US
Telephone Number : 559-412-7799
Fax Number : 559-241-0105
Provider Business Practice Location Address
First Line : 2549 W SHAW AVE
Second Line :
City : FRESNO
State : CA
Zip : 93711-3308
Country : US
Telephone Number : 559-412-7799
Fax Number : 559-412-7799
Authorized Official
Title or Position : OPERATIONS DIRECTOR
Name : BEN JOHNSON
Credential :
Telephone Number : 559-412-7799
Provider Enumeration Date : 02/16/2018
Last Update Date : 07/06/2018

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Directions to “OMEGA MENTAL HEALTH ” Practice Location

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