Provider Demographics
NPI:1871681171
Name:FRESNO COUNTY, DCFS- CHILDREN'S MENTAL HEALTH
Entity Type:Organization
Organization Name:FRESNO COUNTY, DCFS- CHILDREN'S MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR LICENSED CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:GIANG
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:559-453-8918
Mailing Address - Street 1:4441 E. KINGS CANYON
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93702-3604
Mailing Address - Country:US
Mailing Address - Phone:559-453-8918
Mailing Address - Fax:559-453-6700
Practice Address - Street 1:3133 N. MILLBROOK
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703
Practice Address - Country:US
Practice Address - Phone:559-453-8918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041000000X302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization