Healthcare Provider Details

I. General information

NPI: 1629022488
Provider Name (Legal Business Name): MARIA JANETTE JERARDI MD, MHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 09/27/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VALLEY HEALTH TEAM CFCHC 4711 W. ASHLAN AVENUE
FRESNO CA
93722
US

IV. Provider business mailing address

4711 W. ASHLAN AVENUE
FRESNO CA
93722
US

V. Phone/Fax

Practice location:
  • Phone: 559-203-6660
  • Fax: 559-892-0322
Mailing address:
  • Phone: 559-203-6660
  • Fax: 559-892-0322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA87492
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: