Dwight W Sievert MD Inc
Organization Active NPI Psychiatry Physician · Fresno, CA
NPI 1972509214 · NPPES record last updated Jan 17, 2020
Key facts
- NPI
- 1972509214
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- G47593 (CA)
- Legal business name
- DWIGHT W SIEVERT MD INC
- Practice address
- 7766 N Palm Ave Ste 107
Fresno, CA 93711-5734 - Phone
- (559) 435-0800
- Fax
- (559) 435-7720
- NPI assigned
- Jun 22, 2005
- Organization subpart
- Yes
- Parent organization (as reported)
- DWIGHT W SIEVERT MD INC
Authorized official
- Name
- Ms. Syuzanna Torosian
- Title
- Administrator
- Phone
- (559) 435-0800
Practitioners 19
-
Dwight William Sievert, M.D.
-
Brian Taylor, PA
-
Chika Agulanna, PMHNP-BC
-
Stacy Avila Manning, RN,FNP-C
-
Cheryl Anne Hixson, LMFT
-
Mallory Amanda Lewis, AMFT
-
Andranik Avakian, PMHNP-C
-
Smadar Aviv, PHD
-
John Thomas Bachman, MID-LEV PRACTITIONER
-
Lisa M Brandis, LMFT
-
Cory Daniel Jaques, M.D.
-
Manvinder Kaur, RN, FNP
-
Mai Sa Lao, PMHNP
-
Laura Alice Slagle, MA, LMFT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050310000931 | CA | Part B Supplier - Clinic/Group Practice | 1052365103 |
Receives reassigned benefits from 4 practitioners Practice locations: Fresno, CA |
National Provider Directory
- Part of
- Dwight W Sievert MD Inc
Locations
7766 N Palm Ave
Ste 107
Fresno, CA 93711
Phone (559) 435-0800
7131 N 11th St
Ste 104
Fresno, CA 93720
Phone (559) 435-0800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | G47593 | CA | Yes |
Addresses
Primary practice location
7766 N Palm Ave Ste 107
Fresno, CA 93711-5734
Mailing address
7766 N Palm Ave Ste 107
Fresno, CA 93711-5734
Phone (559) 435-0800
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.