Organization
ELIZABETH IAQUINTO LICENSED MARRIAGE AND FAMILY THERAPIST INC
Active
Other names
Poppy Ridge Wellness and Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH GABRIELLA IAQUINTO MA, LMFT (CEO)
(559) 679-9220
Entity
Organization
Contact information
Practice address
420 BULLARD AVE STE 104, CLOVIS, CA 93612-1054
(559) 934-5296
Mailing address
1431 MORRIS AVE, CLOVIS, CA 93611-1444
(559) 679-9220
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225686769
NPI
CA
Enumeration date
01/31/2025
Last updated
01/31/2025
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