Provider Demographics
NPI:1912117854
Name:MCALISTER, BRUCE EARL (LCSW)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:EARL
Last Name:MCALISTER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 E LESTER AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-1663
Mailing Address - Country:US
Mailing Address - Phone:559-226-3499
Mailing Address - Fax:559-227-2954
Practice Address - Street 1:3748 N 1ST ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-5601
Practice Address - Country:US
Practice Address - Phone:559-221-0076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS79201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical