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NPI Code Detail

MEDICARE: VANESSA ELLE BROWN

MEDICARE: VANESSA ELLE BROWN
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
1101YA0400XAddiction (Substance Use Disorder) Counselor100003ANCA
2106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1780239715
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA ELLE BROWN
Provider Business Mailing Address
First Line : 5168 N BLYTHE AVE STE 102
Second Line :
City : FRESNO
State : CA
Zip : 93722-6478
Country : US
Telephone Number : 559-255-5900
Fax Number : 559-981-1212
Provider Business Practice Location Address
First Line : 5168 N BLYTHE AVE STE 102
Second Line :
City : FRESNO
State : CA
Zip : 93722-6478
Country : US
Telephone Number : 559-255-5900
Fax Number : 559-981-1212
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2019
Last Update Date : 08/12/2024

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Directions to “ VANESSA ELLE BROWN ” Practice Location

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