Healthcare Provider Details

I. General information

NPI: 1588580591
Provider Name (Legal Business Name): DEJANAE MCCARTHY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BULLARD AVE STE 101
CLOVIS CA
93612-1057
US

IV. Provider business mailing address

3605 E MCKENZIE AVE
FRESNO CA
93702-2138
US

V. Phone/Fax

Practice location:
  • Phone: 559-323-8484
  • Fax:
Mailing address:
  • Phone: 916-287-6093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: