Healthcare Provider Details

I. General information

NPI: 1356106025
Provider Name (Legal Business Name): ANGELA HASH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2024
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

997 E CHAMPLAIN DR STE 160
FRESNO CA
93720-0749
US

IV. Provider business mailing address

997 E CHAMPLAIN DR STE 160
FRESNO CA
93720-0749
US

V. Phone/Fax

Practice location:
  • Phone: 559-321-6134
  • Fax:
Mailing address:
  • Phone: 559-338-8872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number814881
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: