Provider Demographics
NPI:1366915423
Name:TRANSCENDENCE PSYCHOLOGICAL SERVICES, PC
Entity type:Organization
Organization Name:TRANSCENDENCE PSYCHOLOGICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAHTAB
Authorized Official - Middle Name:
Authorized Official - Last Name:KAENI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:559-930-5565
Mailing Address - Street 1:4756 W HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-8036
Mailing Address - Country:US
Mailing Address - Phone:310-367-3207
Mailing Address - Fax:
Practice Address - Street 1:2440 W SHAW AVE STE 203
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3300
Practice Address - Country:US
Practice Address - Phone:559-930-5565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty