Healthcare Provider Details

I. General information

NPI: 1023281045
Provider Name (Legal Business Name): RAYMOND WESLEY BUCHANAN LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 02/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 S CENTRAL ST
VISALIA CA
93277-4418
US

IV. Provider business mailing address

1830 S CENTRAL ST
VISALIA CA
93277-4418
US

V. Phone/Fax

Practice location:
  • Phone: 559-730-2969
  • Fax: 559-730-2991
Mailing address:
  • Phone: 559-730-2969
  • Fax: 559-730-2991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 44610
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: