Provider Demographics
NPI:1063126308
Name:CULTIVATING A BETTER YOU
Entity type:Organization
Organization Name:CULTIVATING A BETTER YOU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AYANNA
Authorized Official - Middle Name:KAIA
Authorized Official - Last Name:SCOTT-HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:559-313-9101
Mailing Address - Street 1:7948 N MAPLE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0288
Mailing Address - Country:US
Mailing Address - Phone:559-313-9101
Mailing Address - Fax:
Practice Address - Street 1:7948 N MAPLE AVE STE 104
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0288
Practice Address - Country:US
Practice Address - Phone:559-313-9101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1225345952Medicaid