Healthcare Provider Details

I. General information

NPI: 1578793733
Provider Name (Legal Business Name): NONISH XIONG PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5337 N CONTESSA AVE
FRESNO CA
93723-7618
US

IV. Provider business mailing address

5337 N CONTESSA AVE
FRESNO CA
93723-7618
US

V. Phone/Fax

Practice location:
  • Phone: 559-273-0177
  • Fax:
Mailing address:
  • Phone: 559-273-0177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY29003
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: