Provider Demographics
NPI:1598216301
Name:OLFORD-EDDY PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:OLFORD-EDDY PSYCHOLOGICAL SERVICES
Other - Org Name:BEST BRAIN POSSIBLE
Other - Org Type:Other Name
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDILLO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:559-824-2277
Mailing Address - Street 1:516 W SHAW AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2515
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:516 W SHAW AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2515
Practice Address - Country:US
Practice Address - Phone:559-221-4988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14604101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty