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General NPI Number Information
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NPI Number | 1336263797
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Entity Type | Individual
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Provider Name | JONI DEE CARRASCO MFT
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 259 N HOCKETT ST STE 227
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City | PORTERVILLE
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State | CA
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Zip | 93257-3636
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Country | US
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Telephone | 559-361-8511
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Fax | 559-746-0468
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Provider Business Mailing Address
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Address Line | 11550A ROAD 244
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City | PORTERVILLE
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State | CA
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Zip | 93257
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Country | US
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Telephone | 559-361-8511
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Fax | 559-746-0468
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 47661
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License Number State | CA
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