Healthcare Provider Details

I. General information

NPI: 1205165750
Provider Name (Legal Business Name): CLAUDIA RUTH-RANKIN COLEMAN AS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2009
Last Update Date: 12/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4705 N SONORA AVE STE 113
FRESNO CA
93722-3966
US

IV. Provider business mailing address

4705 N SONORA AVE STE 113
FRESNO CA
93722-3966
US

V. Phone/Fax

Practice location:
  • Phone: 559-276-7558
  • Fax: 559-276-7568
Mailing address:
  • Phone: 559-276-7558
  • Fax: 559-276-7568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: