Individual
NICKI BRENDA LUJANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2550 W CLINTON AVE, BUILDING A, SUITE 116, FRESNO, CA 93705-4227
(559) 408-4643
Mailing address
2550 W CLINTON AVE, BUILDING A & H, SUITE 116, FRESNO, CA 93705-4227
(559) 408-4643
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12171
CA
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
MPSS-NQHTYC
CA
Other
Enumeration date
02/02/2021
Last updated
09/25/2024
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