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General NPI Number Information
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NPI Number | 1871869669
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Entity Type | Individual
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Provider Name | GRACE ANN MAHONEY LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 4447 E. CESAR CHAVEZ BLVD
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City | FRESNO
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State | CA
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Zip | 93702-4804
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Country | US
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Telephone | 559-600-0646
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Fax | 559-600-9135
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Provider Business Mailing Address
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Address Line | 6094 N PLEASANT AVE
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City | FRESNO
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State | CA
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Zip | 93711-2267
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Country | US
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Telephone | 559-905-9521
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 69402
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 97366
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License Number State | CA
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