Healthcare Provider Details

I. General information

NPI: 1952970568
Provider Name (Legal Business Name): ALYSSA RAE NERI-GUERRERO APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2021
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6051 N FRESNO ST STE 201
FRESNO CA
93710-5280
US

IV. Provider business mailing address

6051 N FRESNO ST STE 201
FRESNO CA
93710-5280
US

V. Phone/Fax

Practice location:
  • Phone: 559-248-8550
  • Fax:
Mailing address:
  • Phone: 559-248-8550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC8913
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8913
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: