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General NPI Number Information
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NPI Number | 1154531499
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Entity Type | Individual
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Provider Name | PHYLICIA OLIVEIRA LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9300 VALLEY CHILDRENS PL
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City | MADERA
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State | CA
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Zip | 93638-8761
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Country | US
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Telephone | 559-353-3000
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Fax | 559-353-5286
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Provider Business Mailing Address
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Address Line | 6634 N ROOSEVELT AVE
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City | FRESNO
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State | CA
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Zip | 93704-1035
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Country | US
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Telephone | 559-432-6182
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LSS10159
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License Number State | CA
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