MISS SANDRA MANSOUR (NPI# 1093024473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093024473 |
| Entity Type | Individual |
| Full Name | MISS SANDRA MANSOUR |
| Credential | M.A. |
| Practice Address |
3443 W Shaw Ave Sullivan Center for Children Fresno CA 93711-3249 |
| Practice Telephone | 5592711176 |
| Mailing Telephone | 5592711176 |
| Enumeration Date | 2010-10-01 |
| Last Update Date | 2010-10-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PSB 35440 | CA | Behavioral Health & Social Service Providers |
| Street Address |
3443 W SHAW AVE SULLIVAN CENTER FOR CHILDREN |
| City | FRESNO |
| State | CA |
| Zip Code | 93711-3249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396800405 | Katherine Alexandra Redwine | Psychologist | 3443 W Shaw Ave, Fresno, CA 93711-3204 | 2006-12-27 |
| 1609345891 | Kathleen Coleman | Student in an Organized Health Care Education/Training Program | 3443 W Shaw Ave, Fresno, CA 93711-3249 | 2018-11-16 |
| 1396211546 | Alicia Marie Houts | Student in an Organized Health Care Education/Training Program | 3443 W Shaw Ave, Fresno, CA 93711-3249 | 2018-10-15 |
| 1588143960 | Michael Jordan Young | Psychologist | 3443 W Shaw Ave, Fresno, CA 93711-3249 | 2018-08-07 |
| 1689129231 | Rachel Canning | Psychologist | 3443 W Shaw Ave, Fresno, CA 93711-3249 | 2016-08-23 |
| 1154875789 | Kaitlyn Nichols | Psychologist | 3443 W Shaw Ave, Fresno, CA 93711-3249 | 2016-08-11 |
| 1366843229 | Melissa Wagner | Psychologist | 3443 W Shaw Ave, Fresno, CA 93711-3249 | 2014-09-10 |
| 1093116956 | Brittny Torrence | Psychologist | 3443 W Shaw Ave, Fresno, CA 93711-3249 | 2014-09-10 |
| 1861738569 | Nancy Hand-ronga | Psychologist | 3443 W Shaw Ave, Fresno, CA 93711-3249 | 2012-12-27 |
| 1265712046 | Pamela L Deroian | Psychologist | 3443 W Shaw Ave, Fresno, CA 93711-3249 | 2011-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104464684 | Kazi Shafiul Moula | Dentist | Western Dental/ Brident 150bfo, 3077 W Shaw Ave, Fresno, CA 93711 | 2019-12-16 |
| 1760037063 | Armine Petrosyan | Nurse Practitioner | 427 W Beford Ave Suite 103, Fresno, CA 93711 | 2019-08-05 |
| 1912489360 | Shoua Nelson | Nurse Practitioner | 2490 W. Shaw Avenue Suite 101, Fresno, CA 93711 | 2018-09-02 |
| 1245725506 | Promesa Behavioral Health-barstow | Community Based Residential Treatment Facility, Mental Illness | 1415 W Barstow Ave, Fresno, CA 93711 | 2018-06-28 |
| 1407344138 | Aidan Mechem | Behavior Technician | 5140 N. Fruit Avene, Fresno, CA 93711 | 2018-04-27 |
| 1841798840 | Michael Ramos IIi | Behavior Technician | 1690 N Shaw Ave, 102, Fresno, CA 93711 | 2018-01-25 |
| 1962913467 | Dhara Devendrakumar Patel | Pharmacist | 740 West Alluvial Avenue, Suite 101, Fresno, CA 93711 | 2017-10-24 |
| 1588183636 | Bianca Arteaga | Counselor | 7485 N. Palm Ave., Suite 103, Fresno, CA 93711 | 2017-09-10 |
| 1346763158 | Powell Pediatric Dentistry Ingram Partnership | Dentist | 7761 N Ingram Ave, Suite 101, Fresno, CA 93711 | 2017-07-24 |
| 1982124202 | Justine Syera Balbas | Counselor | 2766 W. Celeste Ave., Unit 103, Fresno, CA 93711 | 2017-06-27 |
| Find all providers in zip 93711 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285839456 | Alison Elise Armstrong-conner | Psychologist | 6475 N. Palm Avenue, Suite 101, Fresno, CA 93704 | 2007-06-18 |
| 1043395759 | Kathryn A Cannon | Psychologist | 1300 W Shaw Ave, Suite 1-b, Fresno, CA 93711-3712 | 2006-10-25 |
| 1104986587 | Michelle Therese Olson | Psychologist | 4785 N 1st St, Fresno, CA 93726-0513 | 2006-12-08 |
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| 1235778614 | Jessica Herbold | Psychologist | 1044 Sir Francis Drake Blvd Ste 7, Kentfield, CA 94904-1454 | 2020-01-02 |
| 1003478405 | Melissa Berrenge-browde | Psychologist | 820 Bay Avenue, Suite 205, Capitola, CA 95010-2102 | 2019-07-05 |
| 1811555840 | Rebecca Cole | Psychologist | 5149 High Meadow Court, Fremont, CA 94536 | 2019-06-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.