Healthcare Provider Details

I. General information

NPI: 1114306909
Provider Name (Legal Business Name): DUNAMIS.INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2015
Last Update Date: 05/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S CHESTNUT AVE
FRESNO CA
93702-3907
US

IV. Provider business mailing address

4991 E MCKINLEY AVE
FRESNO CA
93727-1900
US

V. Phone/Fax

Practice location:
  • Phone: 559-981-2143
  • Fax:
Mailing address:
  • Phone: 559-981-2143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. ORLANDO GILLAM II
Title or Position: CEO
Credential:
Phone: 559-981-2143