Healthcare Provider Details

I. General information

NPI: 1811560287
Provider Name (Legal Business Name): ASCEND PSYCHIATRIC GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1791 E FIR AVE STE 102
FRESNO CA
93720-3840
US

IV. Provider business mailing address

1791 E FIR AVE STE 102
FRESNO CA
93720-3840
US

V. Phone/Fax

Practice location:
  • Phone: 559-459-6000
  • Fax:
Mailing address:
  • Phone: 559-459-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW TATUM
Title or Position: CEO
Credential:
Phone: 559-593-9801