MEDICARE: MR. NONISH XIONG PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY29003	CA
2	103T00000X	Psychologist

General Provider Information

NPI Number	:	1578793733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NONISH XIONG PSYD

Provider Business Mailing Address
First Line	:	5337 N CONTESSA AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93723-7618
Country	:	US
Telephone Number	:	559-273-0177
Fax Number	:

Provider Business Practice Location Address
First Line	:	5337 N CONTESSA AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93723-7618
Country	:	US
Telephone Number	:	559-273-0177
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2009
Last Update Date	:	02/06/2024

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