Individual
BIANCA GISELLE BUSTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3520 E SHIELDS AVE, FRESNO, CA 93726-6923
(559) 538-1230
Mailing address
3520 E SHIELDS AVE, FRESNO, CA 93726-6923
(559) 538-1230
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
91303
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/05/2018
Last updated
02/07/2022
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