Healthcare Provider Details

I. General information

NPI: 1881733053
Provider Name (Legal Business Name): ROHINA FAZIL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3451 W SHAW AVE
FRESNO CA
93711-3242
US

IV. Provider business mailing address

369 16TH ST
KERMAN CA
93630-1997
US

V. Phone/Fax

Practice location:
  • Phone: 559-492-8327
  • Fax:
Mailing address:
  • Phone: 254-648-8659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29287
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: