MEDICARE: STACEY R. TORIGIAN LCSW

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	1041C0700X	Clinical Social Worker	LCS 12116	CA

General Provider Information

NPI Number	:	1881750404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY R. TORIGIAN LCSW

Provider Business Mailing Address
First Line	:	551 E VASSAR AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93704-6027
Country	:	US
Telephone Number	:	559-221-8518
Fax Number	:	559-221-8518

Provider Business Practice Location Address
First Line	:	5707 N PALM AVE
Second Line	:	SUITE 103
City	:	FRESNO
State	:	CA
Zip	:	93704-1843
Country	:	US
Telephone Number	:	559-435-3168
Fax Number	:	559-221-8518

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

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	07/08/2007

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