Healthcare Provider Details

I. General information

NPI: 1851065114
Provider Name (Legal Business Name): MARISELA HINOJOS-GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 TULARE ST STE 200
FRESNO CA
93721-2281
US

IV. Provider business mailing address

2440 TULARE ST STE 200
FRESNO CA
93721-2281
US

V. Phone/Fax

Practice location:
  • Phone: 559-443-4800
  • Fax: 559-233-1080
Mailing address:
  • Phone: 559-443-4800
  • Fax: 559-233-1080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11953
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: