Healthcare Provider Details

I. General information

NPI: 1336865567
Provider Name (Legal Business Name): M. H. FAMILY COUNSELING AND CONSULTING, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2022
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 N FOWLER AVE APT 132
CLOVIS CA
93611-6696
US

IV. Provider business mailing address

1187 N WILLOW AVE # 103-880
CLOVIS CA
93611-4411
US

V. Phone/Fax

Practice location:
  • Phone: 559-241-8085
  • Fax:
Mailing address:
  • Phone: 559-241-8085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. MAIRA M. HERNANDEZ
Title or Position: CEO / LMFT
Credential: LMFT
Phone: 559-241-8085