Healthcare Provider Details

I. General information

NPI: 1497191233
Provider Name (Legal Business Name): MARIA TERRY GELDRES-BECERRA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 S ZEDIKER AVE
PARLIER CA
93648-2666
US

IV. Provider business mailing address

2705 HIGHLAND AVE
SELMA CA
93662-3389
US

V. Phone/Fax

Practice location:
  • Phone: 559-646-3561
  • Fax: 559-646-6676
Mailing address:
  • Phone: 559-891-9003
  • Fax: 559-891-9005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number86911
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: