Healthcare Provider Details

I. General information

NPI: 1174314983
Provider Name (Legal Business Name): LAURA ROMERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4928 E CLINTON WAY STE 108
FRESNO CA
93727-1526
US

IV. Provider business mailing address

4811 N WINERY CIR APT 112
FRESNO CA
93726-1521
US

V. Phone/Fax

Practice location:
  • Phone: 559-252-6844
  • Fax: 559-252-1121
Mailing address:
  • Phone: 559-801-4867
  • Fax: 559-252-1121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: