Provider Demographics
NPI:1881733053
Name:FAZIL, ROHINA
Entity type:Individual
Prefix:
First Name:ROHINA
Middle Name:
Last Name:FAZIL
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 1:369 16TH ST
Mailing Address - Street 2:
Mailing Address - City:KERMAN
Mailing Address - State:CA
Mailing Address - Zip Code:93630-1997
Mailing Address - Country:US
Mailing Address - Phone:254-648-8659
Mailing Address - Fax:
Practice Address - Street 1:3451 W SHAW AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3242
Practice Address - Country:US
Practice Address - Phone:559-492-8327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA292871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical