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General NPI Number Information
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NPI Number | 1205370400
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Entity Type | Individual
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Provider Name | MIGUEL ORNELAS LCSW
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Gender | Male
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Dates
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Enumeration Date | 12/07/2016
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 2740 S ELM AVE
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City | FRESNO
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State | CA
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Zip | 93706-5435
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Country | US
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Telephone | 559-457-5200
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Fax | 559-457-5200
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Provider Business Mailing Address
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Address Line | 2740 S ELM AVE
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City | FRESNO
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State | CA
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Zip | 93706-5435
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Country | US
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Telephone | 559-457-5200
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Fax | 559-457-5296
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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 | LCSW92405
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License Number State | CA
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