Organization
INTEGRA LLC
Active
Organization
INTEGRA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHEL CASADOS PHD (CEO)
(559) 813-0461
Entity
Organization
Contact information
Practice address
1911 N FINE AVE, FRESNO, CA 93727-1510
(559) 813-0461
Mailing address
1911 N FINE AVE, FRESNO, CA 93727-1510
(559) 813-0461
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0200X
Forensic Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
103TS0200X
School Psychologist
—
—
Other
Enumeration date
04/12/2024
Last updated
04/12/2024
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