Provider Demographics
NPI:1982374484
Name:NUCLEUS BEHAVIORAL PSYCHOLOGY CORP
Entity Type:Organization
Organization Name:NUCLEUS BEHAVIORAL PSYCHOLOGY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:RYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-246-8722
Mailing Address - Street 1:5080 N FRUIT AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3062
Mailing Address - Country:US
Mailing Address - Phone:559-493-5609
Mailing Address - Fax:559-283-8301
Practice Address - Street 1:5080 N FRUIT AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3062
Practice Address - Country:US
Practice Address - Phone:559-493-5609
Practice Address - Fax:559-283-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty