Healthcare Provider Details

I. General information

NPI: 1295244218
Provider Name (Legal Business Name): MRS. CHENENA RASHELLE KNOX-WARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHENENA R KNOXWARD ACSW91411

II. Dates (important events)

Enumeration Date: 09/21/2017
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 N CEDAR AVE STE 108
FRESNO CA
93726-2538
US

IV. Provider business mailing address

5811 E BYRD AVE
FRESNO CA
93727
US

V. Phone/Fax

Practice location:
  • Phone: 559-248-1548
  • Fax:
Mailing address:
  • Phone: 559-351-8336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW91411
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: