Provider Demographics
NPI:1699972919
Name:OHANESIAN, DEBORAH LOUISE (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LOUISE
Last Name:OHANESIAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:LOUISE
Other - Last Name:OHANESIAN-SANCHEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:5100 N. SIXTH ST.
Mailing Address - Street 2:143
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7506
Mailing Address - Country:US
Mailing Address - Phone:559-244-3262
Mailing Address - Fax:559-244-3262
Practice Address - Street 1:5100 N. SIXTH ST.
Practice Address - Street 2:143
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7506
Practice Address - Country:US
Practice Address - Phone:559-244-3262
Practice Address - Fax:559-244-3262
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6481103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA19461964Medicare PIN