Healthcare Provider Details

I. General information

NPI: 1346076700
Provider Name (Legal Business Name): HANNAH KAY-HELEN DEBONO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2549 W SHAW AVE
FRESNO CA
93711-3308
US

IV. Provider business mailing address

2549 W SHAW AVE
FRESNO CA
93711-3308
US

V. Phone/Fax

Practice location:
  • Phone: 559-264-7521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95345030
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: