Healthcare Provider Details

I. General information

NPI: 1043967847
Provider Name (Legal Business Name): AUBRIE KATHLEEN REYES ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS AUBRIE KATHLEEN YEPIZ-COOK

II. Dates (important events)

Enumeration Date: 03/02/2022
Last Update Date: 12/07/2024
Certification Date: 12/07/2024
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

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

V. Phone/Fax

Practice location:
  • Phone: 559-600-4878
  • Fax: 559-321-2322
Mailing address:
  • Phone: 559-600-4878
  • Fax: 559-321-2322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW106278
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: