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General NPI Number Information
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NPI Number | 1003201575
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Entity Type | Individual
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Provider Name | MARISA ROMERO
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Gender | Female
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Dates
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Enumeration Date | 04/01/2015
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Last Update Date | 11/06/2015
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Provider Practice Location Address
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Address Line | 3147 N MILLBROOK AVE
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City | FRESNO
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State | CA
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Zip | 93703-1425
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Country | US
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Telephone | 559-600-4468
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Fax |
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Provider Business Mailing Address
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Address Line | 414 W RIALTO AVE
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City | CLOVIS
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State | CA
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Zip | 93612-4249
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Country | US
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Telephone | 559-367-2573
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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