Basic Information
| Provider Information | |||||||||
| NPI: | 1891866992 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUNKEL | ||||||||
| FirstName: | ERIC | ||||||||
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| Credential: | PSY.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4910 E CLINTON WAY | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937271560 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594535203 | ||||||||
| FaxNumber: | 5594533321 | ||||||||
| Practice Location | |||||||||
| Address1: | 445 S CEDAR AVE | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937022907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594996464 | ||||||||
| FaxNumber: | 5594996463 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TB0200X | PSY 14931 | CA | Y | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral |
No ID Information.