Provider Demographics
NPI:1942608732
Name:ANDRADE, RAQUEL ESTHER (LMFT110591)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:ESTHER
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:LMFT110591
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 E SHAW AVE # 447
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7602
Mailing Address - Country:US
Mailing Address - Phone:559-899-4137
Mailing Address - Fax:
Practice Address - Street 1:4441 E KINGS CANYON RD
Practice Address - Street 2:FRESNO COUNTY DEPARTMNET OF BEHAVIORAL HEALTH
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-3604
Practice Address - Country:US
Practice Address - Phone:559-600-9180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT110591106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist