Healthcare Provider Details

I. General information

NPI: 1326502683
Provider Name (Legal Business Name): ERIN CHRYSAFIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2019
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5048 N JACKSON AVE
FRESNO CA
93740-0001
US

IV. Provider business mailing address

5048 N JACKSON AVE
FRESNO CA
93740-0001
US

V. Phone/Fax

Practice location:
  • Phone: 559-278-6779
  • Fax:
Mailing address:
  • Phone: 559-278-6779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-40613
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: