Healthcare Provider Details

I. General information

NPI: 1881750404
Provider Name (Legal Business Name): STACEY R. TORIGIAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5707 N PALM AVE SUITE 103
FRESNO CA
93704-1843
US

IV. Provider business mailing address

551 E VASSAR AVE
FRESNO CA
93704-6027
US

V. Phone/Fax

Practice location:
  • Phone: 559-435-3168
  • Fax: 559-221-8518
Mailing address:
  • Phone: 559-221-8518
  • Fax: 559-221-8518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS 12116
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: