| California State University Fresno Foundation | |
|
5048 N Jackson Ave M S Ls138 Fresno CA 93740-0001 | |
| (559) 278-6773 | |
| Not Available |
| Full Name | California State University Fresno Foundation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5048 N Jackson Ave M S Ls138, Fresno, California |
| Authorized Official Name and Position | Amanda Adams (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5592781028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| California State University Fresno Foundation 5048 N Jackson Ave M S Ls138 Fresno CA 93740-0001 Ph: (559) 278-6773 | California State University Fresno Foundation 5048 N Jackson Ave M S Ls138 Fresno CA 93740-0001 Ph: (559) 278-6773 |
| NPI Number | 1295171007 |
|---|---|
| Provider Enumeration Date | 05/20/2013 |
| Last Update Date | 05/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295171007 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1-12-12031 (California) | Primary |
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