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General NPI Number Information
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NPI Number | 1043702178
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Entity Type | Individual
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Provider Name | MISS EMMA ISABELLE REDA
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Gender | Female
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Dates
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Enumeration Date | 06/04/2018
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Last Update Date | 06/19/2024
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Provider Practice Location Address
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Address Line | 1060 W SIERRA AVE STE 105
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City | FRESNO
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State | CA
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Zip | 93711-2063
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Country | US
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Telephone | 155-943-7111
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Fax |
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Provider Business Mailing Address
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Address Line | 3533 N HORNET AVE
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City | FRESNO
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State | CA
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Zip | 93737-9580
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Country | US
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Telephone | 559-760-7687
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 112970
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 112970
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License Number State | CA
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