Provider Demographics
NPI:1609992627
Name:OSUNA, RANDY (PHD)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:
Last Name:OSUNA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 N PALM AVE
Mailing Address - Street 2:STE 605
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2208
Mailing Address - Country:US
Mailing Address - Phone:559-441-3538
Mailing Address - Fax:
Practice Address - Street 1:5151 N PALM AVE
Practice Address - Street 2:STE 605
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2208
Practice Address - Country:US
Practice Address - Phone:559-441-3538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20702103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical