Healthcare Provider Details

I. General information

NPI: 1003757865
Provider Name (Legal Business Name): KONOCSHAY PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5610 W DONNER AVE
FRESNO CA
93722-3721
US

IV. Provider business mailing address

PO BOX 26622
FRESNO CA
93729-6622
US

V. Phone/Fax

Practice location:
  • Phone: 559-352-0860
  • Fax:
Mailing address:
  • Phone: 559-352-0860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW138736
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: