Healthcare Provider Details

I. General information

NPI: 1275786410
Provider Name (Legal Business Name): NEAL J KENNINGTON PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2008
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 FAIRMONT AVE
CLOVIS CA
93611-4014
US

IV. Provider business mailing address

1675 FAIRMONT AVE
CLOVIS CA
93611-4014
US

V. Phone/Fax

Practice location:
  • Phone: 559-709-6915
  • Fax:
Mailing address:
  • Phone: 559-709-6915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY4195
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY35980
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: