Healthcare Provider Details

I. General information

NPI: 1689053365
Provider Name (Legal Business Name): DUNAMIS.INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2015
Last Update Date: 05/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 N ABBY ST
FRESNO CA
93701-1002
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 Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

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