Healthcare Provider Details

I. General information

NPI: 1770936593
Provider Name (Legal Business Name): DANIEL ALEXANDER SIGUENZA ASW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2016
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2719 N AIR FRESNO DR
FRESNO CA
93727-1547
US

IV. Provider business mailing address

2719 N AIR FRESNO DR
FRESNO CA
93727-1547
US

V. Phone/Fax

Practice location:
  • Phone: 559-600-6790
  • Fax:
Mailing address:
  • Phone: 559-600-8918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW108329
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: