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General NPI Number Information
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NPI Number | 1205502044
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Entity Type | Organization
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Legal Business Name | FAMILY FRIENDLY PSYCHOLOGICAL GROUP, P.C.
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Dates
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Enumeration Date | 08/20/2021
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Last Update Date | 09/05/2021
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Provider Practice Location Address
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Address Line | 500 COFFEE RD STE C
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City | MODESTO
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State | CA
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Zip | 95355-4926
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Country | US
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Telephone | 209-408-0896
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Fax |
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Provider Business Mailing Address
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Address Line | 2601 OAKDALE RD STE H2, #171
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City | MODESTO
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State | CA
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Zip | 95355-2256
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Country | US
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Telephone | 209-408-0896
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | DR. FELICIA M AGIBI
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Credential | PSYD
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Telephone | 209-408-0896
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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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