Fresno Mental Psychological Health Services, P.c. | |
4021 N Fresno Street, Ste. 101 Fresno CA 93726 | |
(559) 307-9505 | |
Not Available |
Full Name | Fresno Mental Psychological Health Services, P.c. |
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Speciality | Clinic/Center |
Location | 4021 N Fresno Street, Ste. 101, Fresno, California |
Authorized Official Name and Position | Charmaine Radellant (PSYCHOLOGIST) |
Authorized Official Contact | 5593079505 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Fresno Mental Psychological Health Services, P.c. 4021 N Fresno St Ste 101 Fresno CA 93726-4030 Ph: (559) 307-9505 | Fresno Mental Psychological Health Services, P.c. 4021 N Fresno Street, Ste. 101 Fresno CA 93726 Ph: (559) 307-9505 |
NPI Number | 1356865679 |
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Provider Enumeration Date | 07/28/2017 |
Last Update Date | 07/21/2022 |
Medicare PECOS PAC ID | 2264706977 |
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Medicare Enrollment ID | O20170919003405 |
Identifier | Type | State | Issuer |
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1356865679 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Charmaine J Radellant |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1619194347 PECOS PAC ID: 8123215985 Enrollment ID: I20101207000361 |
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Fresno County California Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 851 Van Ness Ave, Fresno, CA 93721 Phone: 559-488-1318 |