Provider Demographics
NPI:1497191712
Name:MCGRAW SIUTA, VERONICA MICHELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:MICHELLE
Last Name:MCGRAW SIUTA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:VERONICA
Other - Middle Name:MICHELLE
Other - Last Name:MCGRAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:303 E BULLARD AVE APT 150
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5254
Mailing Address - Country:US
Mailing Address - Phone:559-999-6953
Mailing Address - Fax:
Practice Address - Street 1:2100 PEABODY RD
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-6639
Practice Address - Country:US
Practice Address - Phone:707-451-0182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28414103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic