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General NPI Number Information
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NPI Number | 1134048994
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Entity Type | Organization
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Legal Business Name | MOONSTONE PSYCHOLOGICAL SERVICES PC
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Dates
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Enumeration Date | 07/14/2026
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Last Update Date | 07/14/2026
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Provider Practice Location Address
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Address Line | 1625 E SHAW AVE STE 139
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City | FRESNO
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State | CA
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Zip | 93710-8100
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Country | US
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Telephone | 559-478-6971
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Fax | 559-774-1230
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Provider Business Mailing Address
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Address Line | 1740 E SHEPHERD AVE APT 250
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City | FRESNO
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State | CA
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Zip | 93720-5614
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Country | US
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Telephone | 559-478-6971
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Fax | 559-774-1230
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Authorized Official
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Title or Position | PSYD
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Name | ELIZABETH KWONG
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Credential |
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Telephone | 559-478-6971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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