Provider Demographics
NPI:1962054676
Name:FRESNO COUNTY
Entity type:Organization
Organization Name:FRESNO COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:559-600-9058
Mailing Address - Street 1:4468 E CESAR CHAVEZ BLVD BLDG 340
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93702-3605
Mailing Address - Country:US
Mailing Address - Phone:559-600-9171
Mailing Address - Fax:
Practice Address - Street 1:4468 E CESAR CHAVEZ BLVD BLDG 340
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-3605
Practice Address - Country:US
Practice Address - Phone:559-600-9171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF FRESNO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-12
Last Update Date:2024-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)