Healthcare Provider Details

I. General information

NPI: 1518874478
Provider Name (Legal Business Name): NESSA MOUA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 S PEACH AVE
FRESNO CA
93727-4889
US

IV. Provider business mailing address

4447 N HAZEL AVE
FRESNO CA
93722-4121
US

V. Phone/Fax

Practice location:
  • Phone: 559-907-6643
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: