Healthcare Provider Details

I. General information

NPI: 1013826445
Provider Name (Legal Business Name): ADVANCE HEALING THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 W SHAW AVE STE A
FRESNO CA
93711-3612
US

IV. Provider business mailing address

4720 E SAN GABRIEL AVE
FRESNO CA
93726-1838
US

V. Phone/Fax

Practice location:
  • Phone: 559-521-3321
  • Fax: 559-400-6671
Mailing address:
  • Phone: 559-375-3308
  • Fax: 559-400-6671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: SHIRLEY L AGUILAR
Title or Position: OWNER/ MASSAGE THERAPIST
Credential: CMT
Phone: 559-375-3308