Healthcare Provider Details
I. General information
NPI: 1700463577
Provider Name (Legal Business Name): HARNEET BRAICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/26/2021
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3451 W SHAW AVE
FRESNO CA
93711-3242
US
IV. Provider business mailing address
3451 W SHAW AVE
FRESNO CA
93711-3242
US
V. Phone/Fax
- Phone: 559-202-3423
- Fax: 559-412-4693
- Phone: 559-202-3423
- Fax: 559-412-4693
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | AMFT157974 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: