Healthcare Provider Details

I. General information

NPI: 1760257950
Provider Name (Legal Business Name): LIRA MAE ROMERO NUNEZ MSN, PMHNP-BC, CMSRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2023
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N FRESNO ST STE 220
FRESNO CA
93703-3843
US

IV. Provider business mailing address

1300 N FRESNO ST STE 220
FRESNO CA
93703-3843
US

V. Phone/Fax

Practice location:
  • Phone: 559-495-6707
  • Fax: 559-495-6782
Mailing address:
  • Phone: 559-495-6707
  • Fax: 559-495-6782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95225294
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95040042
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: