Provider Demographics
NPI:1568878932
Name:FRESNO PACIFIC UNIVERSITY DBA PACIFIC COUNSELING CENTER
Entity type:Organization
Organization Name:FRESNO PACIFIC UNIVERSITY DBA PACIFIC COUNSELING CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:JAYNE
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:559-453-8060
Mailing Address - Street 1:1717 S CHESTNUT AVE # 14
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93702-4709
Mailing Address - Country:US
Mailing Address - Phone:559-453-8050
Mailing Address - Fax:559-453-8040
Practice Address - Street 1:4812 E BUTLER AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-5014
Practice Address - Country:US
Practice Address - Phone:559-453-8050
Practice Address - Fax:559-453-8040
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESNO PACIFIC UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-07
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty