Individual
JASON GRAVANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2335 E KASHIAN LN STE 301, FRESNO, CA 93701-2234
(559) 459-6394
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
(559) 443-2682
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY30197
CA
Other
Enumeration date
08/10/2018
Last updated
01/28/2021
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