Healthcare Provider Details

I. General information

NPI: 1699679233
Provider Name (Legal Business Name): RAY FISHER HOME ACCESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6629 N BLACKSTONE AVE
FRESNO CA
93710-3503
US

IV. Provider business mailing address

6629 N BLACKSTONE AVE
FRESNO CA
93710-3503
US

V. Phone/Fax

Practice location:
  • Phone: 559-437-3800
  • Fax: 559-437-3838
Mailing address:
  • Phone: 559-437-3800
  • Fax: 559-437-3838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHOUA YANG
Title or Position: ACCOUNTS RECEIVABLE
Credential:
Phone: 559-437-3800