Healthcare Provider Details

I. General information

NPI: 1811538879
Provider Name (Legal Business Name): ALFREDO LOZANO, LMFT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2019
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3134 WILLOW AVE STE 103
CLOVIS CA
93612-4747
US

IV. Provider business mailing address

2905 SW BRIGHT RD APT 21
BENTONVILLE AR
72713-4302
US

V. Phone/Fax

Practice location:
  • Phone: 559-335-3808
  • Fax: 479-364-0018
Mailing address:
  • Phone: 559-335-3808
  • 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: ALFREDO LOZANO
Title or Position: OWNER
Credential: M.S., LMFT
Phone: 559-335-3808