Healthcare Provider Details

I. General information

NPI: 1245158393
Provider Name (Legal Business Name): CALIXTA CAMILE NUNEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 ROAD 35
MADERA CA
93636-8487
US

IV. Provider business mailing address

2610 W SHAW LN
FRESNO CA
93711-2775
US

V. Phone/Fax

Practice location:
  • Phone: 559-645-3580
  • Fax:
Mailing address:
  • Phone: 559-437-1144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: