Healthcare Provider Details

I. General information

NPI: 1073254157
Provider Name (Legal Business Name): KRISTEN NAVIA CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6197 E TERRACE AVE
FRESNO CA
93727-8960
US

IV. Provider business mailing address

6197 E TERRACE AVE
FRESNO CA
93727-8960
US

V. Phone/Fax

Practice location:
  • Phone: 559-269-3295
  • Fax:
Mailing address:
  • Phone: 559-269-3295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: