Provider Demographics
NPI:1720538721
Name:JODI MITCHELL, LMFT
Entity Type:Organization
Organization Name:JODI MITCHELL, LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:559-260-9450
Mailing Address - Street 1:334 W SHAW AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2600
Mailing Address - Country:US
Mailing Address - Phone:559-260-9450
Mailing Address - Fax:
Practice Address - Street 1:334 W SHAW AVE
Practice Address - Street 2:SUITE A
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2600
Practice Address - Country:US
Practice Address - Phone:559-260-9450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA93340251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health