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Organization
KENT PSYCHIATRY
Active
Organization
KENT PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATASHA WALLACE MD (MEDICAL DOCTOR)
(718) 270-1000
Entity
Organization
Contact information
Practice address
1584 N MIDDLEBURG LN, CLOVIS, CA 93619-0412
(718) 270-1000
Mailing address
1134 E CHAMPLAIN DR STE 101, FRESNO, CA 93720-5033
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/29/2022
Last updated
02/08/2023
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