Healthcare Provider Details

I. General information

NPI: 1588688519
Provider Name (Legal Business Name): BRADLEY ALLEN SCHUYLER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 06/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 N 1ST ST STE 138
FRESNO CA
93710
US

IV. Provider business mailing address

6700 N 1ST ST STE 138
FRESNO CA
93710-3956
US

V. Phone/Fax

Practice location:
  • Phone: 559-227-1977
  • Fax: 559-227-2698
Mailing address:
  • Phone: 559-227-1977
  • Fax: 559-227-2698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY8600
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY8600
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: