Individual provider · NPI-1

Mirra Justine Frias

Day Training/Habilitation Specialist · Clovis, CA

NPI number1609740422
StatusActive
Last updated in NPPESOct 3, 2025

Details

NPI
1609740422
Entity type
Individual (NPI-1)
Name
Mirra Justine Frias
Sex
Female
Sole proprietor
No
Enumeration date
Oct 3, 2025
Certification date
Oct 3, 2025
Last updated
Oct 3, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
373H00000X Day Training/Habilitation Specialist–CAYes

Practice location

90 W Ashlan Ave Ste 100
Clovis, CA 93612-5627

Phone 559-313-1426

Mailing address

5761 E Tower Ave
Fresno, CA 93727-6471

Phone 559-313-1426

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