Healthcare Provider Details

I. General information

NPI: 1578865457
Provider Name (Legal Business Name): ZE VANG LMFT # 104480
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2010
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4855 E CESAR CHAVEZ BLVD
FRESNO CA
93727-3811
US

IV. Provider business mailing address

4879 E CESAR CHAVEZ BLVD
FRESNO CA
93727-3811
US

V. Phone/Fax

Practice location:
  • Phone: 559-255-8395
  • Fax:
Mailing address:
  • Phone: 559-313-6338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number104480
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: