Healthcare Provider Details

I. General information

NPI: 1588331185
Provider Name (Legal Business Name): ALMA HUIZAR SRISUKWATANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2021
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2179 AIR FRESNO DRIVE
FRESNO CA
93727
US

IV. Provider business mailing address

2179 AIR FRESNO DRIVE
FRESNO CA
93727
US

V. Phone/Fax

Practice location:
  • Phone: 559-600-8918
  • Fax: 559-600-7709
Mailing address:
  • Phone: 559-600-8918
  • Fax: 559-600-7709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number104350
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number133981
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: