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Organization

SULLIVAN CENTER FOR CHILDREN A PSYCHOLOGICAL CORPORATION

Active
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Organization

SULLIVAN CENTER FOR CHILDREN A PSYCHOLOGICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KATHLEEN MARIE SULLIVAN PH.D. (CLINICAL DIRECTOR)
(559) 271-1186
Entity
Organization

Contact information

Practice address
3443 W SHAW AVE, FRESNO, CA 93711-3204
(559) 271-1186
(559) 271-8041
Mailing address
3443 W SHAW AVE, FRESNO, CA 93711-3204
(559) 271-1186
(559) 271-8041

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PSY10706
CA
103TC0700X
Clinical Psychologist
PSY13503
CA
103TC0700X
Clinical Psychologist
PSY14397
CA
103TC0700X
Clinical Psychologist
PSY16553
CA
103TC0700X
Clinical Psychologist
PSY17724
CA
103TC0700X
Clinical Psychologist
PSY20803
CA
103TC0700X
Clinical Psychologist
Primary
PSY7395
CA
1041C0700X
Clinical Social Worker
LCS19049
CA
106H00000X
Marriage & Family Therapist
MFC24833
CA
106H00000X
Marriage & Family Therapist
MFC42432
CA
106H00000X
Marriage & Family Therapist
MFC42565
CA
2084P0804X
Child & Adolescent Psychiatry Physician
G34063
CA

Other

Enumeration date
01/22/2007
Last updated
12/05/2018
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