Provider Demographics
NPI:1346213352
Name:SINGLETARY, DEJUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEJUAN
Middle Name:
Last Name:SINGLETARY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEJUAN
Other - Middle Name:THERESA
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:327 S K ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-5416
Mailing Address - Country:US
Mailing Address - Phone:559-688-2043
Mailing Address - Fax:559-685-5633
Practice Address - Street 1:4411 E KINGS CANYON RD
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-3604
Practice Address - Country:US
Practice Address - Phone:559-558-4051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD262532084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR133983Medicare PIN
ORH14616Medicare UPIN