Healthcare Provider Details

I. General information

NPI: 1265361406
Provider Name (Legal Business Name): YAMILETHE KURBS PALACIOS CHACON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 E SHAW AVE STE 149
FRESNO CA
93710-7903
US

IV. Provider business mailing address

4657 N STATE ST
FRESNO CA
93722-8661
US

V. Phone/Fax

Practice location:
  • Phone: 559-554-9710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: