Healthcare Provider Details
I. General information
NPI: 1306762489
Provider Name (Legal Business Name): RALPH AND CHANG PSYCHOLOGICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5311 PIRRONE RD
SALIDA CA
95368-9089
US
IV. Provider business mailing address
PO BOX 4978
MODESTO CA
95352-4978
US
V. Phone/Fax
- Phone: 209-575-4575
- Fax: 209-575-4598
- Phone: 209-575-4575
- Fax: 209-575-4598
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NORBERT
RALPH
Title or Position: OWNER
Credential: PHD
Phone: 209-575-4575