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NPI Code Detail

MEDICARE: ELIZABETH CALLEJA GARCIA

MEDICARE: ELIZABETH CALLEJA GARCIA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164X00000XLicensed Vocational Nurse717458CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1717458OTHERCALVN

General Provider Information

NPI Number : 1073187852
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH CALLEJA GARCIA
Provider Business Mailing Address
First Line : 4336 N CORNELIA AVE
Second Line :
City : FRESNO
State : CA
Zip : 93722-4382
Country : US
Telephone Number : 559-312-3018
Fax Number :
Provider Business Practice Location Address
First Line : 2719 N AIR FRESNO DR
Second Line :
City : FRESNO
State : CA
Zip : 93727-1547
Country : US
Telephone Number : 559-600-9180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2021
Last Update Date : 06/19/2023

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Directions to “ ELIZABETH CALLEJA GARCIA ” Practice Location

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