Healthcare Provider Details

I. General information

NPI: 1467944314
Provider Name (Legal Business Name): XOCHITL YAZMIN ZARAGOZA AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2018
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 W FALLBROOK AVE STE 105
FRESNO CA
93711-6191
US

IV. Provider business mailing address

25433 AVENUE 18 3/4
MADERA CA
93638-9663
US

V. Phone/Fax

Practice location:
  • Phone: 559-472-0501
  • Fax:
Mailing address:
  • Phone: 559-382-8023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number130285
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: