Basic Information
| Provider Information | |||||||||
| NPI: | 1568027241 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DHILLON | ||||||||
| FirstName: | MENORJIT | ||||||||
| MiddleName: | SINGH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3433 W SHAW AVE STE 102 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937113229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5595584051 | ||||||||
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| Practice Location | |||||||||
| Address1: | 301 E 13TH ST STE D | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953416211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093861096 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2019 | ||||||||
| LastUpdateDate: | 06/23/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 374700000X | N | Nursing Service Related Providers | Technician | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.