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Individual

XAINYAVONG VANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
412 F ST, FRESNO, CA 93706-3409
(559) 498-6689
Mailing address
412 F ST, FRESNO, CA 93706-3409
(559) 288-2112

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
7454
CA
101YM0800X
Mental Health Counselor
APCC7454
CA
101YP2500X
Professional Counselor
16877
CA
101YP2500X
Professional Counselor
Primary
LPCC16877
CA
171M00000X
Case Manager/Care Coordinator
LPCC16877
CA

Other

Enumeration date
05/13/2020
Last updated
06/19/2025
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