Healthcare Provider Details

I. General information

NPI: 1861069098
Provider Name (Legal Business Name): JAMIEE BRYANT-BATTLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2021
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2547 W SHAW AVE STE 117
FRESNO CA
93711-3321
US

IV. Provider business mailing address

2547 W SHAW AVE STE 117
FRESNO CA
93711-3321
US

V. Phone/Fax

Practice location:
  • Phone: 559-412-7799
  • Fax:
Mailing address:
  • Phone: 559-412-7799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number137821
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: