Healthcare Provider Details

I. General information

NPI: 1063171833
Provider Name (Legal Business Name): ARLENE MARIA NUNEZ GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2021
Last Update Date: 12/09/2021
Certification Date: 12/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W BELGRAVIA AVE
FRESNO CA
93706-3909
US

IV. Provider business mailing address

900 W BELGRAVIA AVE
FRESNO CA
93706-3909
US

V. Phone/Fax

Practice location:
  • Phone: 559-265-2045
  • Fax:
Mailing address:
  • Phone: 559-265-2045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberE162530
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: