Healthcare Provider Details

I. General information

NPI: 1356272751
Provider Name (Legal Business Name): JEREMY LUKE HOWARD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21633 AVENUE 24
CHOWCHILLA CA
93610-9650
US

IV. Provider business mailing address

7232 N STACIA AVE
FRESNO CA
93720-0311
US

V. Phone/Fax

Practice location:
  • Phone: 559-665-6100
  • Fax:
Mailing address:
  • Phone: 904-755-4949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: