Healthcare Provider Details

I. General information

NPI: 1518701424
Provider Name (Legal Business Name): KRISTEN MARIE TREXLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/24/2024
Certification Date: 06/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 KINGS COUNTY DR STE 102
HANFORD CA
93230-5954
US

IV. Provider business mailing address

7575 N CEDAR AVE STE 102
FRESNO CA
93720-2693
US

V. Phone/Fax

Practice location:
  • Phone: 559-415-6588
  • Fax:
Mailing address:
  • Phone: 595-203-3775
  • Fax: 559-326-0607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: