Provider Demographics
NPI:1851486732
Name:FRANASIAK, EDWIN JOSEPH (PHD)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:JOSEPH
Last Name:FRANASIAK
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:P O BOX 2591
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92263
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:68 615 PEREZ ROAD
Practice Address - Street 2:SUITE 6A
Practice Address - City:CATHEDRAL CITY
Practice Address - State:PA
Practice Address - Zip Code:92234
Practice Address - Country:US
Practice Address - Phone:760-770-2220
Practice Address - Fax:760-770-2249
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12918103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical