Healthcare Provider Details

I. General information

NPI: 1740905322
Provider Name (Legal Business Name): JKW HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2022
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 E WARNER AVE STE 102
FRESNO CA
93710-4030
US

IV. Provider business mailing address

2845 E GOSHEN AVE
FRESNO CA
93720-0528
US

V. Phone/Fax

Practice location:
  • Phone: 559-512-7313
  • Fax: 559-512-7153
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: JIAKUN WANG
Title or Position: PRESIDENT
Credential:
Phone: 615-423-9545