Provider Demographics
NPI:1811537830
Name:VASSAR, DESTINY LEE (CATC-II, CADC-I)
Entity type:Individual
Prefix:
First Name:DESTINY
Middle Name:LEE
Last Name:VASSAR
Suffix:
Gender:F
Credentials:CATC-II, CADC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 N FRESNO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93703-1128
Mailing Address - Country:US
Mailing Address - Phone:559-939-5999
Mailing Address - Fax:
Practice Address - Street 1:130 W BARSTOW AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2156
Practice Address - Country:US
Practice Address - Phone:559-939-5999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2025-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist