Basic Information
| Provider Information | |||||||||
| NPI: | 1780734459 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARIBAY | ||||||||
| FirstName: | FIDEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 91 LESTER AVE | ||||||||
| Address2: | |||||||||
| City: | CLOVIS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936197594 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5593241268 | ||||||||
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| Practice Location | |||||||||
| Address1: | 245 S. MADERA AVE | ||||||||
| Address2: | |||||||||
| City: | KERMAN | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93630 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5598467500 | ||||||||
| FaxNumber: | 5598465892 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.