Healthcare Provider Details

I. General information

NPI: 1841116902
Provider Name (Legal Business Name): DANIEL VERA ASW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3451 W SHAW AVE STE 101
FRESNO CA
93711-3242
US

IV. Provider business mailing address

3451 W SHAW AVE STE 101
FRESNO CA
93711-3242
US

V. Phone/Fax

Practice location:
  • Phone: 559-260-6754
  • Fax:
Mailing address:
  • Phone: 559-260-6754
  • Fax: 559-412-4693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW139654
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: