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General NPI Number Information
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NPI Number | 1912347741
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Entity Type | Organization
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Legal Business Name | CLOVIS HYBRID AUTISM PROGRAM (CHAPS)
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Dates
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Enumeration Date | 06/25/2013
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Last Update Date | 06/25/2013
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Provider Practice Location Address
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Address Line | 965 N SUNNYSIDE AVE
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City | CLOVIS
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State | CA
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Zip | 93611-8171
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Country | US
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Telephone | 559-327-8400
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Fax | 559-327-8179
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Provider Business Mailing Address
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Address Line | 965 N SUNNYSIDE AVE
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City | CLOVIS
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State | CA
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Zip | 93611-8171
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Country | US
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Telephone | 559-327-8400
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. SHERRI GIBSON
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Credential | PH.D
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Telephone | 559-327-9434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | #PSY12625
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License Number State | CA
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