Healthcare Provider Details

I. General information

NPI: 1396919577
Provider Name (Legal Business Name): PATRICIA ANN FOLEY LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 12/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3103 E CARTWRIGHT AVE
FRESNO CA
93725
US

IV. Provider business mailing address

1900 LAKE TAHOE BLVD
SOUTH LAKE TAHOE CA
96150-6305
US

V. Phone/Fax

Practice location:
  • Phone: 559-498-7100
  • Fax: 559-498-7111
Mailing address:
  • Phone: 530-573-3251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN190121
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: