Organization
FRESNO COUNTY
Active
Other names
Fresno County Medical Team
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN L HOLT LMFT (DIRECTOR)
(559) 600-9058
Entity
Organization
Contact information
Practice address
2719 N AIR FRESNO DR, FRESNO, CA 93727-1547
(559) 453-8918
Mailing address
2719 N AIR FRESNO DR, FRESNO, CA 93727-1547
(559) 453-8918
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
000001045
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000001045
—
CA
01
—
2230
COST CENTER
—
Enumeration date
03/02/2007
Last updated
12/30/2022
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