Healthcare Provider Details

I. General information

NPI: 1588776918
Provider Name (Legal Business Name): INDIRA DEVI ADAPA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7341 N 1ST ST STE 110
FRESNO CA
93720-2948
US

IV. Provider business mailing address

10090 N PAGE AVE
FRESNO CA
93720-4502
US

V. Phone/Fax

Practice location:
  • Phone: 559-860-9314
  • Fax: 559-549-6666
Mailing address:
  • Phone: 559-434-3796
  • Fax: 559-434-3796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA86927
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA86927
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: