Individual
DR. SAM L BANSAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
667 FAIRHAVEN CIR, PORTERVILLE, CA 93257-2025
(805) 712-1023
(559) 781-1023
Mailing address
667 FAIRHAVEN CIR, PORTERVILLE, CA 93257-2025
(805) 712-1023
(559) 781-1023
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
11/22/2013
Last updated
11/22/2013
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