Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Phousavanh Southisombath

Individual provider Behavior Technician · NPI 1295497360

Phousavanh Southisombath is a Behavior Technician in Fresno, California. Practices as a sole proprietor. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

1401 Fulton St Ste 200
Fresno, CA 93721-1646
Phone: (559) 348-9225
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1295497360
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 6, 2021
Last updated in NPPESOctober 6, 2021
Certification dateOctober 6, 2021

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