Basic Information
| Provider Information | |||||||||
| NPI: | 1427721265 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VIERRA | ||||||||
| FirstName: | JANET | ||||||||
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| Credential: | ACSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3433 W SHAW AVE STE 102 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937113229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093128008 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1539 MCHENRY AVE | ||||||||
| Address2: | |||||||||
| City: | MODESTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953504528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2097020139 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2021 | ||||||||
| LastUpdateDate: | 07/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 102173 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.