Provider Demographics
NPI:1528397700
Name:GAMEZ, ADRIAN ALFONSO
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:ALFONSO
Last Name:GAMEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3528 N BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-6340
Mailing Address - Country:US
Mailing Address - Phone:559-862-3349
Mailing Address - Fax:
Practice Address - Street 1:2855 W WHITES BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-1231
Practice Address - Country:US
Practice Address - Phone:559-268-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)