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General NPI Number Information
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NPI Number | 1124819313
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Entity Type | Organization
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Legal Business Name | SHINE CAMPUS FAMILY COUNSELING INC
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 525 N HALL ST STE B
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City | VISALIA
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State | CA
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Zip | 93291-4639
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Country | US
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Telephone | 559-657-6167
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Fax | 559-236-0410
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Provider Business Mailing Address
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Address Line | 1125 S SOWELL ST
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City | VISALIA
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State | CA
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Zip | 93277-2440
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Country | US
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Telephone | 559-667-7387
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GRISELDA S VALENCIA
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Credential | LMFT
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Telephone | 559-667-7387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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