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Individual

DR. CHARMAINE RADELLANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4025 N FRESNO ST STE 102, FRESNO, CA 93726-4027
(559) 307-9505
Mailing address
POST OFFICE BOX 842, FRESNO, CA 93712
(559) 307-9505

Taxonomy

Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
PSY22964
CA
103TC0700X
Clinical Psychologist
Primary
PSY22964
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY22964
CA
103TF0200X
Forensic Psychologist
PSY22964
CA
103TP2701X
Group Psychotherapy Psychologist
PSY22964
CA

Other

Enumeration date
04/20/2007
Last updated
11/10/2011
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