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General NPI Number Information
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NPI Number | 1447139274
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Entity Type | Individual
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Provider Name | ALICIA M STOUTEMIRE LCSW, PPSC
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Gender | Female
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 2011 FRESNO ST
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City | FRESNO
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State | CA
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Zip | 93721-1722
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Country | US
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Telephone | 559-547-3340
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Fax | 559-457-3373
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Provider Business Mailing Address
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Address Line | 5555 E. TULARE AVE. PO BOX 8858
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City | FRESNO
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State | CA
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Zip | 93747-8858
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Country | US
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Telephone | 559-312-5553
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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 | 118161
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License Number State | CA
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