Healthcare Provider Details

I. General information

NPI: 1609182815
Provider Name (Legal Business Name): NORTH FRESNO FAMILY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 01/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6081 N 1ST ST SUITE 104
FRESNO CA
93710-5466
US

IV. Provider business mailing address

6081 N 1ST ST SUITE 104
FRESNO CA
93710-5466
US

V. Phone/Fax

Practice location:
  • Phone: 559-436-5265
  • Fax: 559-436-4958
Mailing address:
  • Phone: 559-436-5265
  • Fax: 559-436-4958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number386046
License Number StateCA

VIII. Authorized Official

Name: JULIE ANNE GUYETTE
Title or Position: OWNER/OPERATOR
Credential: FNP
Phone: 559-436-5265