MEDICARE: KAREN L. FU MFT

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	106H00000X	Marriage & Family Therapist	MFC 36438	CA

General Provider Information

NPI Number	:	1790809895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN L. FU MFT

Provider Business Mailing Address
First Line	:	4420 N 1ST ST
Second Line	:	SUITE 121
City	:	FRESNO
State	:	CA
Zip	:	93726-2331
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4420 N 1ST ST
Second Line	:	SUITE 121
City	:	FRESNO
State	:	CA
Zip	:	93726-2331
Country	:	US
Telephone Number	:	559-244-5880
Fax Number	:

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

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	07/08/2007

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