Active NPI
Pamela L Deroian, PHD
- Clinical Psychologist
- Fresno, CA
National Provider Identifier
1265712046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY4703
- Practice address
- 3443 W Shaw Ave
Fresno, CA 93711-3249 - Phone
- (559) 271-1186
- Fax
- (559) 271-8041
- NPI assigned
- Aug 24, 2011
- Last updated
- Aug 24, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY4703 | FL | Primary |
Addresses
Primary practice location
3443 W Shaw Ave
Fresno, CA 93711-3249
Mailing address
3443 W Shaw Ave
Fresno, CA 93711-3249
Phone (559) 271-1186
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY4703 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314144000000",
"number": "1265712046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3443 W SHAW AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937113249",
"telephone_number": "559-271-1186",
"fax_number": "559-271-8041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3443 W SHAW AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937113249",
"telephone_number": "559-271-1186",
"fax_number": "559-271-8041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEROIAN",
"first_name": "PAMELA",
"middle_name": "L",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-24",
"last_updated": "2011-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY4703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
- Ani Hagop Derboghossian, PHARMD
- Haig Derboghossian
- Jason Derhovanesian, DO
- Adam Hicham Derkouch, PHARMD
- Wilfred Derksen, MD
- Mark Derr
- Derric Brown LCSW, Licensed Clinical Social Worker Inc. (Streams of Hope Behavioral Health Care)
- Alessandra Gose Desabelle, DDS
- Jason Michael Desadier, D.O.
- Angela Desai, N.P.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.