Provider Demographics
NPI:1174646954
Name:POWROZNIK, JAMES ALLISON (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALLISON
Last Name:POWROZNIK
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:MR
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:POWROZNIK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:4420 N 1ST ST
Mailing Address - Street 2:SUITE 121
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-2331
Mailing Address - Country:US
Mailing Address - Phone:559-916-0411
Mailing Address - Fax:
Practice Address - Street 1:4420 N 1ST ST
Practice Address - Street 2:SUITE 121
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-2331
Practice Address - Country:US
Practice Address - Phone:559-916-0411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43539106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist