Provider Demographics
NPI:1811543747
Name:DR. SCOGGINS, INC.
Entity Type:Organization
Organization Name:DR. SCOGGINS, INC.
Other - Org Name:FRESNO HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCOGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:559-246-8679
Mailing Address - Street 1:2023 N PREUSS AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-7464
Mailing Address - Country:US
Mailing Address - Phone:559-246-8679
Mailing Address - Fax:
Practice Address - Street 1:2023 N PREUSS AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93619-7464
Practice Address - Country:US
Practice Address - Phone:559-246-8679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-15
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty