MEDICARE: ROSELYN E NUNEZ LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	1041C0700X	Clinical Social Worker	89709	CA

General Provider Information

NPI Number	:	1538354634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSELYN E NUNEZ LCSW

Provider Business Mailing Address
First Line	:	5447 N ROSALIA AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93723-7642
Country	:	US
Telephone Number	:	559-367-1431
Fax Number	:

Provider Business Practice Location Address
First Line	:	7575 N CEDAR AVE STE 102
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-2693
Country	:	US
Telephone Number	:	559-203-3775
Fax Number	:	559-326-0607

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2007
Last Update Date	:	09/07/2023

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