Healthcare Provider Details
I. General information
NPI: 1780201954
Provider Name (Legal Business Name): SABRINA SYVANKHAM LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/02/2020
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7265 N 1ST ST STE 103
FRESNO CA
93720-2956
US
IV. Provider business mailing address
PO BOX 25533
FRESNO CA
93729-5533
US
V. Phone/Fax
- Phone: 559-426-8619
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 21787 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: