=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275141681
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TORIBIO PSYCHOLOGICAL SERVICES, PROFESSIONAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/22/2020
-----------------------------------------------------
Last Update Date | 04/29/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3475 W SHAW AVE STE 101
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93711-3200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-271-1186
-----------------------------------------------------
Fax | 559-234-4523
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3475 W SHAW AVE STE 101
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93711-3200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-586-6778
-----------------------------------------------------
Fax | 559-234-4523
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL DIRECTOR
-----------------------------------------------------
Name | DR. JANET SAENZ TORIBIO
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 559-271-1186
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------