Provider Demographics
NPI:1992958938
Name:MEDRANO-COLON, ELEANOR
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:
Last Name:MEDRANO-COLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2343 E HOME AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93703-3712
Mailing Address - Country:US
Mailing Address - Phone:559-312-0802
Mailing Address - Fax:
Practice Address - Street 1:707 N FULTON ST STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93728-3405
Practice Address - Country:US
Practice Address - Phone:559-486-6080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)