Healthcare Provider Details

I. General information

NPI: 1154368306
Provider Name (Legal Business Name): PAUL PASION-GONZALEZ PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 EAST OAK STREET
VISALIA CA
93291-5034
US

IV. Provider business mailing address

305 EAST CENTER AVE
VISALIA CA
93291-6331
US

V. Phone/Fax

Practice location:
  • Phone: 559-741-4500
  • Fax: 559-741-4502
Mailing address:
  • Phone: 559-737-4700
  • Fax: 559-737-4782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY15139
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: