Healthcare Provider Details

I. General information

NPI: 1811540958
Provider Name (Legal Business Name): VICTORIA NEIL PENDLETON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICTORIA NEIL SALDANA

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 S MOONEY BLVD
VISALIA CA
93277-9396
US

IV. Provider business mailing address

6200 S MOONEY BLVD
VISALIA CA
93277-9396
US

V. Phone/Fax

Practice location:
  • Phone: 559-747-3984
  • Fax: 559-747-3642
Mailing address:
  • Phone: 559-747-3984
  • Fax: 559-747-3642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: