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General NPI Number Information
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NPI Number | 1780199711
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Entity Type | Organization
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Legal Business Name | RESILIENCE AND WELLNESS COUNSELING
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Dates
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Enumeration Date | 12/13/2017
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Last Update Date | 12/13/2017
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Provider Practice Location Address
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Address Line | 1012 11TH ST STE LL4
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City | MODESTO
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State | CA
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Zip | 95354-0827
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Country | US
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Telephone | 209-312-9472
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Fax |
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Provider Business Mailing Address
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Address Line | 3620 MOHAWK LN
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City | MODESTO
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State | CA
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Zip | 95356-0931
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Country | US
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Telephone | 209-480-0211
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Fax |
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Authorized Official
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Title or Position | BEHAVIORAL HEALTH CLINICIAN
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Name | ERIKA AYON NAVARRETE
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Credential | LCSW
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Telephone | 209-480-0211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 75527
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License Number State | CA
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