Provider Demographics
NPI:1336277144
Name:FRESNO COUNTY PATHS
Entity Type:Organization
Organization Name:FRESNO COUNTY PATHS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, FRESNO CO BEHAVIORAL HLTH
Authorized Official - Prefix:MS
Authorized Official - First Name:GIANG
Authorized Official - Middle Name:T
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:559-253-9180
Mailing Address - Street 1:4411 E KINGS CANYON RD
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:559-253-9180
Mailing Address - Fax:
Practice Address - Street 1:515 S CEDAR AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-2908
Practice Address - Country:US
Practice Address - Phone:559-453-8300
Practice Address - Fax:559-453-8916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101030261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA101030Medicaid
CA2093OtherCOST CENTER