Healthcare Provider Details

I. General information

NPI: 1194496513
Provider Name (Legal Business Name): MAYRA DELGADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2021
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 W BIRCH AVE
CLOVIS CA
93611-0205
US

IV. Provider business mailing address

270 W BIRCH AVE
CLOVIS CA
93611-0205
US

V. Phone/Fax

Practice location:
  • Phone: 559-628-0427
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW134750
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: