Healthcare Provider Details

I. General information

NPI: 1063181451
Provider Name (Legal Business Name): VUE FAMILY THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 E SHAW AVE STE 116
FRESNO CA
93710-8007
US

IV. Provider business mailing address

711 W. SHAW AVE., SUITE 112 PMB 71
CLOVIS CA
93612
US

V. Phone/Fax

Practice location:
  • Phone: 559-202-3390
  • Fax: 559-468-0288
Mailing address:
  • Phone: 559-202-3390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: PA KOU VUE
Title or Position: OWNER
Credential: LMFT
Phone: 559-202-3390