Healthcare Provider Details

I. General information

NPI: 1548062888
Provider Name (Legal Business Name): DIANA YANKE XIONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4441 E CESAR CHAVEZ BLVD
FRESNO CA
93702-3604
US

IV. Provider business mailing address

2078 RICHERT AVE
CLOVIS CA
93611-5236
US

V. Phone/Fax

Practice location:
  • Phone: 559-600-9180
  • Fax:
Mailing address:
  • Phone: 559-213-9829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number799392
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: