Healthcare Provider Details

I. General information

NPI: 1609601574
Provider Name (Legal Business Name): AARON CORD OPIE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2024
Last Update Date: 06/24/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1470 W HERNDON AVE STE 300
FRESNO CA
93711-0552
US

IV. Provider business mailing address

1218 E CHAMPLAIN DR APT 102
FRESNO CA
93720-5064
US

V. Phone/Fax

Practice location:
  • Phone: 559-256-2000
  • Fax: 559-256-3000
Mailing address:
  • Phone: 559-612-0078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: