NPI Profile for INTEGRA LLC in FRESNO, CA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Intellectual & Developmental Disabilities |
103TM1800X | 62 | Psychologist, Clinical | |
Clinical |
103TC0700X | 62 | Psychologist, Clinical | |
Clinical Child & Adolescent |
103TC2200X | 62 | Psychologist, Clinical | |
Forensic |
103TF0200X | 62 | Psychologist, Clinical | |
Psychologist |
103T00000X | 62 | Psychologist, Clinical | |
School |
103TS0200X | 62 | Psychologist, Clinical |
| NPI # | 1144074527 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 04/12/2024 | |
| Last updated | 04/12/2024 - About 2 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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INTEGRA LLC
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| MARK D POPPER, PhD 1960 N. GATEWAY BLVD FRESNO, CA |
| SEQUOIA PSYCHOTHERAPY CENTER, INC 1960 N. GATEWAY BLVD FRESNO, CA |
| VANG LENG MOUANOUTOUA, PhD 2211 N. FINE STREET FRESNO, CA |
| KO B FANG, PhD 2822 N. BLACKSTONE AVENUE FRESNO, CA |
| WILLIAM W LATTA, PhD 3133 NORTH MILLBROOK AVE. FRESNO, CA |
| ALEXA H WASSERMAN TONCHEFF, PSY.D. 3128 WILLOW CLOVIS, CA |
| ALEXIA B MORGAN, PHD 106 POLLASKY CLOVIS, CA |
| DARRA HIRSH, PhD 334 SHAW AVE STE 100 CLOVIS, CA |
| SHANITTA D HINES VICTOR COMMUNITY SUPPORT SERVICES 302 CHERRY LANE, CA |
| ANGELA GONZALES MEE MEMORIAL HEALTHCARE SYSTEM 300 CANAL STREET, CA |