Healthcare Provider Details

I. General information

NPI: 1831426451
Provider Name (Legal Business Name): SONAL P PATEL N.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2009
Last Update Date: 08/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1191 E HERNDON AVE SUITE 102
FRESNO CA
93720-3164
US

IV. Provider business mailing address

1191 E HERNDON AVE SUITE 102
FRESNO CA
93720-3164
US

V. Phone/Fax

Practice location:
  • Phone: 559-389-0622
  • Fax: 559-389-0763
Mailing address:
  • Phone: 559-797-1377
  • Fax: 559-201-1412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number091156
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND418
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: