Individual
AMAIRANY FAJARDO I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
302 CHERRY LN STE 101, MANTECA, CA 95337-4311
(209) 647-6200
Mailing address
302 CHERRY LN STE 101, MANTECA, CA 95337-4311
(209) 647-6200
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
CA
104100000X
Social Worker
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/10/2022
Last updated
06/13/2023
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