Healthcare Provider Details

I. General information

NPI: 1508306002
Provider Name (Legal Business Name): CANDIDA ROJAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2017
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 E AMERICAN AVE
FRESNO CA
93725-9247
US

IV. Provider business mailing address

2550 W. CLINTON AVENUE BUILDING B # 128-138
FRESNO CA
93705-1458
US

V. Phone/Fax

Practice location:
  • Phone: 559-600-4876
  • Fax:
Mailing address:
  • Phone: 559-225-9117
  • Fax:

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: