Healthcare Provider Details

I. General information

NPI: 1366360158
Provider Name (Legal Business Name): CARMEN SHURIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 E CLINTON AVE
FRESNO CA
93703-2223
US

IV. Provider business mailing address

382 W TEAGUE AVE
FRESNO CA
93711-6070
US

V. Phone/Fax

Practice location:
  • Phone: 818-590-8434
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number333754
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: