Provider Demographics
NPI:1770035008
Name:CRONE, MATTHEW
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:CRONE
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 1:3122 N MILLBROOK AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93703-1458
Mailing Address - Country:US
Mailing Address - Phone:559-225-9117
Mailing Address - Fax:559-225-9174
Practice Address - Street 1:3122 N MILLBROOK AVE
Practice Address - Street 2:SUITE B
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703-1458
Practice Address - Country:US
Practice Address - Phone:559-225-9117
Practice Address - Fax:559-225-9174
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB7958909101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)