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General NPI Number Information
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NPI Number | 1043755820
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Entity Type | Organization
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Legal Business Name | CALIFORNIA FORENSIC AND CLINICAL PSYCHOLOGY INC
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Dates
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Enumeration Date | 01/03/2017
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 525 W MAIN ST STE B
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City | VISALIA
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State | CA
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Zip | 93291-6116
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Country | US
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Telephone | 559-259-5886
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Fax |
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Provider Business Mailing Address
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Address Line | 525 W MAIN ST STE B
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City | VISALIA
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State | CA
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Zip | 93291-6116
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Country | US
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Telephone | 559-259-5886
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELISABETH KING
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Credential |
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Telephone | 559-259-5886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY20259
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License Number State | CA
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