Individual
BAO HER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
24511 W JAYNE AVE, COALINGA, CA 93210-9503
(559) 934-8212
Mailing address
8260 LONGLEAF DR BLDG C, ELK GROVE, CA 95758-1322
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY35610
CA
Other
Enumeration date
09/09/2018
Last updated
09/04/2025
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