Individual
ALEXANDRA MACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3435 W SHAW AVE, 101, FRESNO, CA 93711-3234
(559) 275-1784
Mailing address
3435 W SHAW AVE, 101, FRESNO, CA 93711-3234
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10AQ
—
CA
Enumeration date
03/04/2013
Last updated
03/04/2013
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