Provider Demographics
NPI:1831603703
Name:CERDA SNIFFIN PSYCHOLOGY GROUP
Entity type:Organization
Organization Name:CERDA SNIFFIN PSYCHOLOGY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:D
Authorized Official - Last Name:SNIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:559-440-1004
Mailing Address - Street 1:6777 N WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5900
Mailing Address - Country:US
Mailing Address - Phone:559-440-1004
Mailing Address - Fax:559-298-1020
Practice Address - Street 1:6777 N WILLOW AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5900
Practice Address - Country:US
Practice Address - Phone:559-440-1004
Practice Address - Fax:559-298-1020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24999103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty