Provider Demographics
NPI:1902093180
Name:PRIMER PASO INSTITUTE, INC
Entity Type:Organization
Organization Name:PRIMER PASO INSTITUTE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:VASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-734-6042
Mailing Address - Street 1:310 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-5009
Mailing Address - Country:US
Mailing Address - Phone:559-734-6042
Mailing Address - Fax:559-635-4788
Practice Address - Street 1:3748 N 1ST ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-5601
Practice Address - Country:US
Practice Address - Phone:559-221-0076
Practice Address - Fax:559-221-0098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty