Provider Demographics
NPI:1861215311
Name:XIONG, SUE SEE
Entity type:Individual
Prefix:
First Name:SUE
Middle Name:SEE
Last Name:XIONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 N GATEWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1604
Mailing Address - Country:US
Mailing Address - Phone:559-266-5200
Mailing Address - Fax:559-266-5201
Practice Address - Street 1:1960 N GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1604
Practice Address - Country:US
Practice Address - Phone:559-266-5200
Practice Address - Fax:559-266-5201
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1210281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical