Provider Demographics
NPI:1073135075
Name:THAO, VUE TUE
Entity Type:Individual
Prefix:
First Name:VUE
Middle Name:TUE
Last Name:THAO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2477 S WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93725-1828
Mailing Address - Country:US
Mailing Address - Phone:559-801-2347
Mailing Address - Fax:
Practice Address - Street 1:2731 W OLIVE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93728-2449
Practice Address - Country:US
Practice Address - Phone:559-233-5096
Practice Address - Fax:559-233-5099
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1375370120101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)