Healthcare Provider Details

I. General information

NPI: 1447166608
Provider Name (Legal Business Name): MRS. JOHANNA CHAMBERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 VAN NESS AVE
FRESNO CA
93721-2002
US

IV. Provider business mailing address

2381 SKANSEN ST
KINGSBURG CA
93631-2711
US

V. Phone/Fax

Practice location:
  • Phone: 559-265-3008
  • Fax:
Mailing address:
  • Phone: 559-265-3008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number21435
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: