Healthcare Provider Details

I. General information

NPI: 1417834250
Provider Name (Legal Business Name): PA VUE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 08/20/2025
Certification Date: 08/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7265 N 1ST ST STE 105
FRESNO CA
93720-2956
US

IV. Provider business mailing address

3632 E CLAY AVE APT D
FRESNO CA
93702-1161
US

V. Phone/Fax

Practice location:
  • Phone: 559-431-8181
  • Fax:
Mailing address:
  • Phone: 559-724-5730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number308660
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: