Healthcare Provider Details

I. General information

NPI: 1720498553
Provider Name (Legal Business Name): ENRIQUE LORENZO SAENZ JUAREZ ASW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 N COURT ST
VISALIA CA
93291-3638
US

IV. Provider business mailing address

711 N COURT ST
VISALIA CA
93291-3638
US

V. Phone/Fax

Practice location:
  • Phone: 559-627-1490
  • Fax:
Mailing address:
  • Phone: 559-627-1490
  • 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 Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: