Healthcare Provider Details

I. General information

NPI: 1538354634
Provider Name (Legal Business Name): ROSELYN E NUNEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2007
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7575 N CEDAR AVE STE 102
FRESNO CA
93720-2693
US

IV. Provider business mailing address

5447 N ROSALIA AVE
FRESNO CA
93723-7642
US

V. Phone/Fax

Practice location:
  • Phone: 559-203-3775
  • Fax: 559-326-0607
Mailing address:
  • Phone: 559-367-1431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number89709
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: