Healthcare Provider Details

I. General information

NPI: 1760095194
Provider Name (Legal Business Name): OSENA HEALTH CONNECT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2020
Last Update Date: 08/25/2020
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1192 CARSON AVE
CLOVIS CA
93611-8595
US

IV. Provider business mailing address

2491 ALLUVIAL AVE # PB618
CLOVIS CA
93611-9587
US

V. Phone/Fax

Practice location:
  • Phone: 559-765-7755
  • Fax:
Mailing address:
  • Phone: 559-245-6464
  • Fax: 559-354-5902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DENNIS CLYDE OSENA
Title or Position: PRESIDENT CEO
Credential: FNP-BC
Phone: 559-765-7755