Healthcare Provider Details

I. General information

NPI: 1508031030
Provider Name (Legal Business Name): CALIFORNIA PSYCHOLOGICAL INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1470 W HERNDON AVE
FRESNO CA
93711-0552
US

IV. Provider business mailing address

1470 W HERNDON AVE
FRESNO CA
93711-0552
US

V. Phone/Fax

Practice location:
  • Phone: 559-256-2000
  • Fax: 559-256-3000
Mailing address:
  • Phone: 559-256-2000
  • Fax: 559-256-3000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE LEE OWHADI
Title or Position: ADMINISTRATIVE DIRECTOR
Credential: MS
Phone: 559-256-2000