MEDICARE: JOSE ANDRES LEDEZMA CERVANTES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1487336756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE ANDRES LEDEZMA CERVANTES

Provider Business Mailing Address
First Line	:	PO BOX 25533
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93729-5533
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7265 N 1ST ST STE 103
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-2956
Country	:	US
Telephone Number	:	559-374-2732
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2023
Last Update Date	:	05/07/2026

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Directions to “ JOSE ANDRES LEDEZMA CERVANTES ” Practice Location

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