Healthcare Provider Details

I. General information

NPI: 1922983113
Provider Name (Legal Business Name): NULEK SINGKEOVILAY PSYCHOLOGIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 N COURT ST
VISALIA CA
93291-4913
US

IV. Provider business mailing address

2615 N SALLEE ST
VISALIA CA
93291-8075
US

V. Phone/Fax

Practice location:
  • Phone: 559-754-3011
  • Fax:
Mailing address:
  • Phone: 559-372-5370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number94028196
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: