Healthcare Provider Details

I. General information

NPI: 1053881516
Provider Name (Legal Business Name): JANELY CERDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2018
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5081 E LANE AVE
FRESNO CA
93727-4838
US

IV. Provider business mailing address

1221 E PERRIN AVE APT 206
FRESNO CA
93720-5051
US

V. Phone/Fax

Practice location:
  • Phone: 559-920-1027
  • Fax:
Mailing address:
  • Phone: 559-920-1027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number461305562
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: