Provider Demographics
NPI:1053903583
Name:GARIBAY, VANESSA M (AMFT)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:M
Last Name:GARIBAY
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 SHAW AVE # 232
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-3932
Mailing Address - Country:US
Mailing Address - Phone:559-228-9020
Mailing Address - Fax:
Practice Address - Street 1:5675 E ASHLAN AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-7220
Practice Address - Country:US
Practice Address - Phone:559-228-9020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95913106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist