Healthcare Provider Details

I. General information

NPI: 1255995254
Provider Name (Legal Business Name): KHUSBU PATEL OROZCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KHUSBU SHAILESH PATEL

II. Dates (important events)

Enumeration Date: 04/24/2019
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6051 N FRESNO ST STE 201
FRESNO CA
93710
US

IV. Provider business mailing address

6051 N FRESNO ST STE 201
FRESNO CA
93710-5280
US

V. Phone/Fax

Practice location:
  • Phone: 559-248-8550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number148124
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: