Healthcare Provider Details

I. General information

NPI: 1043160765
Provider Name (Legal Business Name): GUS FRANCA ANDERSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5965 E SHIELDS AVE UNIT 155
FRESNO CA
93727-8059
US

IV. Provider business mailing address

5965 E SHIELDS AVE UNIT 155
FRESNO CA
93727-8059
US

V. Phone/Fax

Practice location:
  • Phone: 209-681-2760
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number54585
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: