Healthcare Provider Details

I. General information

NPI: 1770867756
Provider Name (Legal Business Name): SELINA ANNE MARIE BARNETT PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SELINA ANNE MARIE DALUZ PHD

II. Dates (important events)

Enumeration Date: 10/07/2011
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 S MOONEY BLVD
VISALIA CA
93277-6228
US

IV. Provider business mailing address

305 E CENTER AVE
VISALIA CA
93291-6331
US

V. Phone/Fax

Practice location:
  • Phone: 877-960-3426
  • Fax: 559-734-1247
Mailing address:
  • Phone: 559-737-4700
  • Fax: 559-734-1247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPSY22504
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number22504
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: