Provider Demographics
NPI:1497942742
Name:MARJAREE MASON CENTER
Entity Type:Organization
Organization Name:MARJAREE MASON CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:KALLSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-237-4706
Mailing Address - Street 1:1600 M ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1122
Mailing Address - Country:US
Mailing Address - Phone:559-237-4706
Mailing Address - Fax:
Practice Address - Street 1:1600 M ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1122
Practice Address - Country:US
Practice Address - Phone:559-237-4706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management