Organization
EDWYN W. ORTIZ-NANCE PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWYN W. ORTIZ-NANCE (CLINICAL PSYCHOLOGIST ADMINISTRATOR)
(559) 252-6353
Entity
Organization
Contact information
Practice address
2080 N WINERY AVE, #101, FRESNO, CA 93703-4817
(559) 252-6353
(559) 252-7964
Mailing address
2080 N WINERY AVE, #101, FRESNO, CA 93703-4817
(559) 252-6353
(559) 252-7964
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
PSB94020449
CA
305R00000X
Preferred Provider Organization
Primary
PSB94020449
CA
Other
Enumeration date
05/15/2014
Last updated
05/15/2014
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