1699972919 NPI number — DR. DEBORAH LOUISE OHANESIAN PH.D

Table of content: DR. DEBORAH LOUISE OHANESIAN PH.D (NPI 1699972919)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699972919 NPI number — DR. DEBORAH LOUISE OHANESIAN PH.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OHANESIAN
Provider First Name:
DEBORAH
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OHANESIAN-SANCHEZ
Provider Other First Name:
DEBORAH
Provider Other Middle Name:
LOUISE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PH.D
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1699972919
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/06/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5100 N. SIXTH ST.
Provider Second Line Business Mailing Address:
143
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93710-7506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-244-3262
Provider Business Mailing Address Fax Number:
559-244-3262

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5100 N. SIXTH ST.
Provider Second Line Business Practice Location Address:
143
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93710-7506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-244-3262
Provider Business Practice Location Address Fax Number:
559-244-3262
Provider Enumeration Date:
06/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  PSY6481 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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