Healthcare Provider Details

I. General information

NPI: 1760232185
Provider Name (Legal Business Name): JESSICA KARINA CAHUIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2024
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N K ST
TULARE CA
93274-4005
US

IV. Provider business mailing address

201 N K ST
TULARE CA
93274-4005
US

V. Phone/Fax

Practice location:
  • Phone: 559-687-8713
  • Fax:
Mailing address:
  • Phone: 559-687-8713
  • Fax:

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 Code101YP2500X
TaxonomyProfessional Counselor
License Number16450
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: