Basic Information
Provider Information
NPI: 1710102058
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VUE
FirstName: BEE
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: RAS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5773 E CHRISTINE AVE
Address2:  
City: FRESNO
State: CA
PostalCode: 937276149
CountryCode: US
TelephoneNumber: 5592531216
FaxNumber:  
Practice Location
Address1: 1310 M ST
Address2:  
City: FRESNO
State: CA
PostalCode: 937211808
CountryCode: US
TelephoneNumber: 5592642700
FaxNumber: 5592642767
Other Information
ProviderEnumerationDate: 04/13/2007
LastUpdateDate: 11/01/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/01/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X5638CAY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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