Provider Demographics
NPI:1700375045
Name:CHANG, CIERA C
Entity Type:Individual
Prefix:MISS
First Name:CIERA
Middle Name:C
Last Name:CHANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3792 N FORESTIERE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-1102
Mailing Address - Country:US
Mailing Address - Phone:559-240-7978
Mailing Address - Fax:
Practice Address - Street 1:3792 N FORESTIERE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-1102
Practice Address - Country:US
Practice Address - Phone:559-240-7978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor