Healthcare Provider Details

I. General information

NPI: 1760861702
Provider Name (Legal Business Name): JOSEPHINE PENALBA-OLDAN HO LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOSEPHINE PENALBA OLDAN

II. Dates (important events)

Enumeration Date: 05/22/2015
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 E MERCED ST
FOWLER CA
93625-2316
US

IV. Provider business mailing address

4785 N 1ST ST
FRESNO CA
93726-0500
US

V. Phone/Fax

Practice location:
  • Phone: 559-892-9452
  • Fax:
Mailing address:
  • Phone: 559-448-4708
  • Fax: 559-448-4950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number101192
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: