Provider Demographics
NPI:1356436729
Name:VOLKOFF, WILLIAM J (MFT LEP)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:VOLKOFF
Suffix:
Gender:M
Credentials:MFT LEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1523 W. MESA
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711
Mailing Address - Country:US
Mailing Address - Phone:559-288-4482
Mailing Address - Fax:559-432-1044
Practice Address - Street 1:5707 N WEST AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-2366
Practice Address - Country:US
Practice Address - Phone:559-432-1088
Practice Address - Fax:559-432-1044
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC21108106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist