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General NPI Number Information
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NPI Number | 1912886722
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Entity Type | Individual
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Provider Name | KRYSTLE LEE CLEVENGER PPS
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Gender | Female
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | PO BOX 368
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City | ARMONA
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State | CA
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Zip | 93202-0368
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Country | US
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Telephone | 559-583-5020
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Fax |
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Provider Business Mailing Address
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Address Line | 1409 S BIRCH AVE
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City | REEDLEY
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State | CA
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Zip | 93654-4123
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Country | US
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Telephone | 559-590-7461
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 230252956
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License Number State | CA
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