Healthcare Provider Details

I. General information

NPI: 1366915423
Provider Name (Legal Business Name): TRANSCENDENCE PSYCHOLOGICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2019
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 W SHAW AVE STE 203
FRESNO CA
93711-3300
US

IV. Provider business mailing address

4756 W HARVARD AVE
FRESNO CA
93722-8036
US

V. Phone/Fax

Practice location:
  • Phone: 559-930-5565
  • Fax:
Mailing address:
  • Phone: 310-367-3207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MAHTAB KAENI
Title or Position: OWNER/ PRESIDENT
Credential: PSYD
Phone: 559-930-5565