Healthcare Provider Details

I. General information

NPI: 1023922234
Provider Name (Legal Business Name): COAST TO VALLEY MARRIAGE & FAMILY THERAPY PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4080 PORTALS AVE
CLOVIS CA
93619-8781
US

IV. Provider business mailing address

PO BOX 1285
CLOVIS CA
93613-1285
US

V. Phone/Fax

Practice location:
  • Phone: 559-599-3931
  • Fax:
Mailing address:
  • Phone: 424-287-7628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: NINA ASHRAFZADEH
Title or Position: PRESIDENT/OWNER
Credential: PSY.D., LMFT
Phone: 424-287-7628