Healthcare Provider Details

I. General information

NPI: 1215103726
Provider Name (Legal Business Name): ANDREW MASAO CONSTANT LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 801
CLOVIS CA
93613-0801
US

IV. Provider business mailing address

PO BOX 801
CLOVIS CA
93613-0801
US

V. Phone/Fax

Practice location:
  • Phone: 559-123-4135
  • Fax:
Mailing address:
  • Phone: 559-123-4135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number91238
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: