Healthcare Provider Details

I. General information

NPI: 1841873346
Provider Name (Legal Business Name): AKAYLA RUTH VARNELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 05/03/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3636 N 1ST ST STE 162
FRESNO CA
93726-6869
US

IV. Provider business mailing address

3636 N 1ST ST STE 162
FRESNO CA
93726-6869
US

V. Phone/Fax

Practice location:
  • Phone: 559-476-2166
  • Fax:
Mailing address:
  • Phone: 559-476-2166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: