Healthcare Provider Details

I. General information

NPI: 1730139866
Provider Name (Legal Business Name): BRANDON FOSTER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 06/20/2011
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 NumberPSB30181
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: