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NPI Code Detail

MEDICARE: MR. FERNANDO RUBEN ESCALANTE MFTI

MEDICARE: MR. FERNANDO RUBEN ESCALANTE MFTI
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
1101YM0800XMental Health CounselorCA

General Provider Information

NPI Number : 1821438920
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. FERNANDO RUBEN ESCALANTE MFTI
Provider Business Mailing Address
First Line : 1630 E SHAW AVE, SUITE 150
Second Line :
City : FRESNO
State : CA
Zip : 93710
Country : US
Telephone Number : 559-240-0878
Fax Number : 559-248-8555
Provider Business Practice Location Address
First Line : 5168 N BLYTHE AVE STE 101
Second Line :
City : FRESNO
State : CA
Zip : 93722-6478
Country : US
Telephone Number : 559-248-8500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2013
Last Update Date : 05/21/2014

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