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UCSF FRESNO MEDICAL GROUP

Clinical Neuropsychologist

Fresno, California

Provider NPI: 1487839932

Organization Information:
Organization Name:  UCSF FRESNO MEDICAL GROUP
Organization is Subpart
Authorized Official:  JOAN  VORIS  ASSOICATE DEAN  559-4996427

Practice Location:
3313 N HILLIARD ST  FRESNO, CA 93726 US
Tel: 559-227-4810  Fax: 559-227-4167

Business Mailing Address:
PO BOX 60000 FILE 740522 SAN FRANCISCO, CA 94160 US
Tel: 559-227-4810  Fax: 559-227-4167

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
CA20822
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
CAPSY19509

Other Provider Identifiers:

IssuerNumberStateType
BLUE OF CAZZZ5296YCA01
NPI1821014374CA01
2342434CA05
RAILROAD MEDICARECK5696CA01
GPS001380CA05
MEDI-CAL PIN9151935CA01
GR0091021CA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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