Healthcare Provider Details

I. General information

NPI: 1023724002
Provider Name (Legal Business Name): ANDREA CRISTINA HUERTA OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2023
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7075 N SHARON AVE
FRESNO CA
93720-3329
US

IV. Provider business mailing address

7075 N SHARON AVE
FRESNO CA
93720-3329
US

V. Phone/Fax

Practice location:
  • Phone: 559-486-2000
  • Fax: 559-256-8575
Mailing address:
  • Phone: 559-389-5723
  • Fax: 415-379-5590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number35288
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: