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General NPI Number Information
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NPI Number | 1972977551
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Entity Type | Organization
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Legal Business Name | REHANA AZIZ MD
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 1557 W SHAW AVE
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City | FRESNO
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State | CA
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Zip | 93711-3503
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Country | US
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Telephone | 559-222-0207
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Fax | 559-222-0200
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Provider Business Mailing Address
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Address Line | 1557 W SHAW AVE
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City | FRESNO
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State | CA
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Zip | 93711-3503
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Country | US
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Telephone | 559-222-0207
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Fax | 559-222-0200
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Authorized Official
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Title or Position | PSYCHIATRIST/CHILD,ADULT,ADOLESCENT
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Name | REHANA AZIZ
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Credential | M.D.
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Telephone | 559-222-0207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | A54063
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License Number State | CA
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