Individual
ALEX ONTIVEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2560 W SHAW LN STE 104, FRESNO, CA 93711-2777
(559) 443-4800
Mailing address
2560 W SHAW LN STE 104, FRESNO, CA 93711-2777
(559) 443-4800
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
149501
CA
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
07/01/2019
Last updated
09/12/2024
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