Healthcare Provider Details

I. General information

NPI: 1023385267
Provider Name (Legal Business Name): LINDA L DELGADO LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2011
Last Update Date: 11/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4441 E KINGS CANYON RD
FRESNO CA
93702-3604
US

IV. Provider business mailing address

2286 3RD ST
SANGER CA
93657-2258
US

V. Phone/Fax

Practice location:
  • Phone: 559-600-4099
  • Fax: 559-455-4743
Mailing address:
  • Phone: 559-875-5956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN 132060
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: