Basic Information
| Provider Information | |||||||||
| NPI: | 1215069950 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOTT | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSY.D., MFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2931 W SILVERHILL LN | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937111174 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594316644 | ||||||||
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| Practice Location | |||||||||
| Address1: | 412 F ST | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937063409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594986988 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2007 | ||||||||
| LastUpdateDate: | 04/21/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 43540 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.