Healthcare Provider Details

I. General information

NPI: 1598744237
Provider Name (Legal Business Name): PATRICIA ANN HURT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4118 S DEMAREE ST
VISALIA CA
93277-9514
US

IV. Provider business mailing address

100 N AKERS ST # 7596
VISALIA CA
93291-5121
US

V. Phone/Fax

Practice location:
  • Phone: 559-372-7758
  • Fax: 559-372-7758
Mailing address:
  • Phone: 559-372-7758
  • Fax: 559-372-7758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS17080
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: