Healthcare Provider Details

I. General information

NPI: 1699972919
Provider Name (Legal Business Name): DEBORAH LOUISE OHANESIAN PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEBORAH LOUISE OHANESIAN-SANCHEZ PH.D

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 N. SIXTH ST. 143
FRESNO CA
93710-7506
US

IV. Provider business mailing address

5100 N. SIXTH ST. 143
FRESNO CA
93710-7506
US

V. Phone/Fax

Practice location:
  • Phone: 559-244-3262
  • Fax: 559-244-3262
Mailing address:
  • Phone: 559-244-3262
  • Fax: 559-244-3262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY6481
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: