Healthcare Provider Details

I. General information

NPI: 1073348314
Provider Name (Legal Business Name): NIA AURORA SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4862 E CLINTON AVE
FRESNO CA
93703-2873
US

IV. Provider business mailing address

4928 E CLINTON AVE #108
FRESNO CA
93727-1526
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number159990
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number159990
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number159990
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: