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NPI Code Detail

MEDICARE: JUANITA JAURA GARCIA

MEDICARE: JUANITA JAURA GARCIA
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCA

General Provider Information

NPI Number : 1619115599
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUANITA JAURA GARCIA
Provider Business Mailing Address
First Line : 4705 N SONORA AVE STE 113
Second Line :
City : FRESNO
State : CA
Zip : 93722-3965
Country : US
Telephone Number : 559-276-7558
Fax Number : 559-276-7568
Provider Business Practice Location Address
First Line : 4705 N SONORA AVE STE 113
Second Line :
City : FRESNO
State : CA
Zip : 93722-3965
Country : US
Telephone Number : 559-276-7558
Fax Number : 559-276-7568
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2009
Last Update Date : 11/09/2020

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Directions to “ JUANITA JAURA GARCIA ” Practice Location

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