Healthcare Provider Details

I. General information

NPI: 1407779044
Provider Name (Legal Business Name): AMBER ELIZABETH ANNA WELLS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2772 S MARTIN L KING JR BLVD
FRESNO CA
93706-5345
US

IV. Provider business mailing address

2772 S MARTIN L KING JR BLVD
FRESNO CA
93706-5345
US

V. Phone/Fax

Practice location:
  • Phone: 559-265-4800
  • Fax:
Mailing address:
  • Phone: 559-265-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number164426
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: