Organization
ASIAN PACIFIC ISLANDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWAN UTECHT (DIR, DBH)
(559) 600-6895
Entity
Organization
Contact information
Practice address
4445 E INYO ST, FRESNO, CA 93702-2977
(559) 253-9131
Mailing address
5108 E CLINTON WAY STE 108, FRESNO, CA 93727-2043
(559) 452-3463
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
000001084
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000001084
—
CA
01
—
2185
COST CENTER
—
Enumeration date
02/05/2007
Last updated
09/25/2013
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