Healthcare Provider Details

I. General information

NPI: 1336327196
Provider Name (Legal Business Name): ALFREDO LOZANO M.S., LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 07/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3134 WILLOW AVE STE 103
CLOVIS CA
93612
US

IV. Provider business mailing address

3134 WILLOW AVE STE 103
CLOVIS CA
93612-4747
US

V. Phone/Fax

Practice location:
  • Phone: 626-327-2846
  • Fax:
Mailing address:
  • Phone: 559-335-3808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number100893
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: