Provider Demographics
NPI:1164035762
Name:LO, HOWARD (LCSW)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:LO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1685 E HOME AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93728-2027
Mailing Address - Country:US
Mailing Address - Phone:559-457-6900
Mailing Address - Fax:559-400-8432
Practice Address - Street 1:1685 E HOME AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93728-2027
Practice Address - Country:US
Practice Address - Phone:559-457-6900
Practice Address - Fax:559-400-8432
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82308101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health