Healthcare Provider Details

I. General information

NPI: 1760167290
Provider Name (Legal Business Name): ALS WELLNESS, MARRIAGE & FAMILY THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 N PALM AVE STE 750
FRESNO CA
93704-2221
US

IV. Provider business mailing address

5593 N 6TH ST
FRESNO CA
93710-6356
US

V. Phone/Fax

Practice location:
  • Phone: 559-801-1480
  • Fax: 559-785-0046
Mailing address:
  • Phone: 559-240-2709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: AMBER SALDATE-STUBBS
Title or Position: OWNER/CEO
Credential: LMFT
Phone: 559-801-1480