Provider Demographics
NPI:1780706713
Name:PRETTIPAUL, ASZAD KEN (PSYD)
Entity type:Individual
Prefix:MR
First Name:ASZAD
Middle Name:KEN
Last Name:PRETTIPAUL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:ASZAD
Other - Middle Name:
Other - Last Name:PRETTIPAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 7805
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93290-7805
Mailing Address - Country:US
Mailing Address - Phone:559-308-1293
Mailing Address - Fax:
Practice Address - Street 1:3000 W CECIL AVE
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-1821
Practice Address - Country:US
Practice Address - Phone:661-721-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
CAPSY23479103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist