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NPI Code Detail

MEDICARE: TYZHA ALEXANDRIA HUERTA

MEDICARE: TYZHA ALEXANDRIA HUERTA
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
1103K00000XBehavior Analyst1-25-86803CA
2171400000XHealth & Wellness CoachCA

General Provider Information

NPI Number : 1730688326
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYZHA ALEXANDRIA HUERTA
Provider Business Mailing Address
First Line : 2011 FRESNO ST
Second Line :
City : FRESNO
State : CA
Zip : 93721-1722
Country : US
Telephone Number : 559-457-3990
Fax Number :
Provider Business Practice Location Address
First Line : 7088 N MAPLE AVE STE 105
Second Line :
City : FRESNO
State : CA
Zip : 93720-0391
Country : US
Telephone Number : 559-372-3628
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2018
Last Update Date : 03/10/2026

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Directions to “ TYZHA ALEXANDRIA HUERTA ” Practice Location

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