Provider Demographics
NPI:1174876163
Name:GALVAN, JOE ANTHONY (LMFT)
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:ANTHONY
Last Name:GALVAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 W SHAW AVE STE E
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3507
Mailing Address - Country:US
Mailing Address - Phone:559-550-4811
Mailing Address - Fax:559-242-0766
Practice Address - Street 1:1617 W SHAW AVE STE E
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3507
Practice Address - Country:US
Practice Address - Phone:559-550-4811
Practice Address - Fax:559-242-0766
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2022-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99203101YM0800X, 106H00000X
CA72142106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health