Healthcare Provider Details

I. General information

NPI: 1891103420
Provider Name (Legal Business Name): GAUKUE XIONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2014
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 E DAKOTA AVE STE 224
FRESNO CA
93726-4804
US

IV. Provider business mailing address

2025 E DAKOTA AVE STE 224
FRESNO CA
93726-4804
US

V. Phone/Fax

Practice location:
  • Phone: 559-259-4658
  • Fax:
Mailing address:
  • Phone: 559-259-4658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLEP4310
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBACB1035583
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: