Provider Demographics
NPI:1720973142
Name:VAZQUEZ, MICHELLE D (PPSC, LCSW)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:D
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:PPSC, LCSW
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:D
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5000 W CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-8300
Mailing Address - Country:US
Mailing Address - Phone:559-735-3519
Mailing Address - Fax:
Practice Address - Street 1:5000 W CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-8300
Practice Address - Country:US
Practice Address - Phone:550-730-7566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041S0200X
CA1276901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool