Idiart, Michael Gene

Idiart, Michael Gene is an individual health care provider with primary practice located at 23370 Road 22 , Chowchilla CA 93610-8504. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Idiart, Michael Gene can be contacted via phone (559) 655-5531.

Contact Information

Primary practice address
23370 Road 22 Chowchilla CA 93610-8504
Phone: (559) 655-5531
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Forensic 103TF0200X California
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY29830 California

Profile Details

NPI number 1902267008
LBN Legal business name Idiart, Michael Gene
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2016
Last updated Jan 12th, 2024 - about 10 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902267008 NPPES
California Other PSY29830 CALIFORNIA BOARD OF PSYCHOLOGY

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