Fresno County
Organization Active NPI Adolescent and Children Mental Health Clinic/Center · Fresno, CA
NPI 1932238482 · NPPES record last updated Dec 30, 2022
Key facts
- NPI
- 1932238482
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adolescent and Children Mental Health Clinic/Center 261QM0855X
- License
- 000001045 (CA)
- Legal business name
- FRESNO COUNTY
- Practice address
- 2719 N Air Fresno Dr
Fresno, CA 93727-1547 - Phone
- (559) 453-8918
- NPI assigned
- Mar 2, 2007
- Organization subpart
- No
Authorized official
- Name
- Susan L Holt, LMFT
- Title
- Director
- Phone
- (559) 600-9058
Corporate family (same tax ID) 18
National Provider Directory
- Tax ID family
- Sierra Foothills HLTH C
Locations
2719 N Air Fresno Dr
Fresno, CA 93727
Phone (559) 600-8918
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | 000001045 | CA | Yes |
Addresses
Primary practice location
2719 N Air Fresno Dr
Fresno, CA 93727-1547
Mailing address
2719 N Air Fresno Dr
Fresno, CA 93727-1547
Phone (559) 453-8918
Other practice location 1
3133 N Millbrook Ave
Fresno, CA 93703-1425
Phone (559) 453-8918
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000001045 | Medicaid | CA | |
| 2230 | Other | COST CENTER |
Other names
- Fresno County Medical Team
Other providers in Fresno, CA
- Fresno County
- Fresno County
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- Fresno County
- Fresno County
- Fresno County
- Fresno County
- Fresno County
- Fresno County Acttc Maa/TCM Program
- Fresno County Adolescent Day Treatment (Adt- Edt)
All providers in Fresno, CA · Adolescent and Children Mental Health Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.