Provider Demographics
NPI:1245809052
Name:FUENTES, HALEY INGRID (LMFT)
Entity type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:INGRID
Last Name:FUENTES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:HALEY
Other - Middle Name:INGRID
Other - Last Name:FUENTES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:698 N CLAREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-7304
Mailing Address - Country:US
Mailing Address - Phone:559-681-8311
Mailing Address - Fax:
Practice Address - Street 1:550 W ALLUVIAL AVE STE 108
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-5857
Practice Address - Country:US
Practice Address - Phone:559-795-5990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA124427106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist