Healthcare Provider Details

I. General information

NPI: 1689585853
Provider Name (Legal Business Name): RAFAEL AGUIRRE JR. PPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 E CLINTON AVE
FRESNO CA
93704-5315
US

IV. Provider business mailing address

2302 RICHERT AVE
CLOVIS CA
93611-3919
US

V. Phone/Fax

Practice location:
  • Phone: 559-248-7370
  • Fax:
Mailing address:
  • Phone: 805-714-7121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number230200814
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: