| 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. |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 07/28/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 2264706977 |
|---|---|
| Medicare Enrollment ID | O20170919003405 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356865679 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Charmaine J Radellant |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619194347 PECOS PAC ID: 8123215985 Enrollment ID: I20101207000361 |
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