Basic Information
| Provider Information | |||||||||
| NPI: | 1083228431 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUNOZ | ||||||||
| FirstName: | MARGARITA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2247 W DAKOTA AVE APT 102 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937052603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5595131713 | ||||||||
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| Practice Location | |||||||||
| Address1: | 258 N BLACKSTONE AVE | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937011913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592740290 | ||||||||
| FaxNumber: | 8446067326 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2020 | ||||||||
| LastUpdateDate: | 12/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | ACSW96377 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 1041C0700X | ASW96377 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.