Healthcare Provider Details

I. General information

NPI: 1093585002
Provider Name (Legal Business Name): ROSA ELENA HERNANDEZ SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROSA ELENA SANCHEZ MENDEZ

II. Dates (important events)

Enumeration Date: 01/02/2024
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1334 W HERNDON AVE
FRESNO CA
93711-0431
US

IV. Provider business mailing address

1334 W HERNDON AVE
FRESNO CA
93711-0431
US

V. Phone/Fax

Practice location:
  • Phone: 559-745-3145
  • Fax:
Mailing address:
  • Phone: 559-375-4990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number131640
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: