Provider Demographics
NPI:1548487176
Name:FRESCAS, RENE ARMANDO (BS)
Entity type:Individual
Prefix:
First Name:RENE
Middle Name:ARMANDO
Last Name:FRESCAS
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 OBISPO AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3833
Mailing Address - Country:US
Mailing Address - Phone:562-434-0622
Mailing Address - Fax:
Practice Address - Street 1:506 E FAIRVIEW AVE APT A
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3039
Practice Address - Country:US
Practice Address - Phone:626-309-0552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health