Healthcare Provider Details

I. General information

NPI: 1497414809
Provider Name (Legal Business Name): CYNTHIA MADELINE ESCOTO LMFT156539
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2021
Last Update Date: 08/01/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 W SHAW LN STE 104
FRESNO CA
93711-2777
US

IV. Provider business mailing address

2560 W SHAW LN STE 104
FRESNO CA
93711-2777
US

V. Phone/Fax

Practice location:
  • Phone: 559-443-4800
  • Fax:
Mailing address:
  • Phone: 559-443-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number156539
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: