Basic Information
| Provider Information | |||||||||
| NPI: | 1003033721 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | UNRUH | ||||||||
| FirstName: | DENNIS | ||||||||
| MiddleName: | KENT | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6632 N MARTY AVE | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937110823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594391870 | ||||||||
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| Practice Location | |||||||||
| Address1: | 14277 ROAD 28 | ||||||||
| Address2: | |||||||||
| City: | MADERA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936385715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596733508 | ||||||||
| FaxNumber: | 5596612818 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | PSY 5690 | CA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.