Healthcare Provider Details

I. General information

NPI: 1487808879
Provider Name (Legal Business Name): MARIBEL NMN RESENDEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2008
Last Update Date: 11/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 N CHINOWTH ST
VISALIA CA
93291-7896
US

IV. Provider business mailing address

1124 N CHINOWTH ST
VISALIA CA
93291-7896
US

V. Phone/Fax

Practice location:
  • Phone: 559-635-4252
  • Fax: 559-635-4281
Mailing address:
  • Phone: 559-635-4252
  • Fax: 559-635-4281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS23726
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: