Provider Demographics
NPI:1568153765
Name:DE ALBA COUNSELING
Entity Type:Organization
Organization Name:DE ALBA COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE ALBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-930-5962
Mailing Address - Street 1:1398 W INDIANAPOLIS AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93705-0300
Mailing Address - Country:US
Mailing Address - Phone:559-930-5962
Mailing Address - Fax:
Practice Address - Street 1:1398 W INDIANAPOLIS AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93705-0300
Practice Address - Country:US
Practice Address - Phone:559-930-5962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)