Provider Demographics
NPI:1912634973
Name:GIRALDES, DESIRAE (LCSW)
Entity Type:Individual
Prefix:
First Name:DESIRAE
Middle Name:
Last Name:GIRALDES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2433
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:CA
Mailing Address - Zip Code:93644-2433
Mailing Address - Country:US
Mailing Address - Phone:408-469-1599
Mailing Address - Fax:209-317-4020
Practice Address - Street 1:40680 HIGHWAY 41 STE D
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:CA
Practice Address - Zip Code:93644-9657
Practice Address - Country:US
Practice Address - Phone:559-684-2084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-01
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106717101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health