Healthcare Provider Details

I. General information

NPI: 1932515145
Provider Name (Legal Business Name): ALICIA AUSTIN-TOWNSEND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2014
Last Update Date: 09/22/2020
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 W CLINTON AVE BLDG W
FRESNO CA
93705-4206
US

IV. Provider business mailing address

2550 W CLINTON AVE UNIT 397
FRESNO CA
93705-4223
US

V. Phone/Fax

Practice location:
  • Phone: 559-264-7521
  • Fax:
Mailing address:
  • Phone: 925-270-6641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT114307
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: