Healthcare Provider Details

I. General information

NPI: 1730007741
Provider Name (Legal Business Name): RAQUEL TADDEI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4625 E FLORENCE AVE
FRESNO CA
93725-1110
US

IV. Provider business mailing address

4625 E FLORENCE AVE
FRESNO CA
93725-1110
US

V. Phone/Fax

Practice location:
  • Phone: 559-253-6420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: