Healthcare Provider Details

I. General information

NPI: 1205732914
Provider Name (Legal Business Name): LAURA CHRISTINE FODDRILL MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2026
Last Update Date: 11/02/2026
Certification Date: 11/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3894 E GETTYSBURG AVE
FRESNO CA
93726-0901
US

IV. Provider business mailing address

636 E NORTHRIDGE DR
DINUBA CA
93618-3059
US

V. Phone/Fax

Practice location:
  • Phone: 559-454-0822
  • Fax:
Mailing address:
  • Phone: 805-464-1345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC24036
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: