Healthcare Provider Details

I. General information

NPI: 1134437825
Provider Name (Legal Business Name): MS. SYLVIA R KELLY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2010
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3572 N BLYTHE AVE # 155
FRESNO CA
93722-6303
US

IV. Provider business mailing address

3572 N BLYTHE AVE # 155
FRESNO CA
93722-6303
US

V. Phone/Fax

Practice location:
  • Phone: 559-552-3946
  • Fax:
Mailing address:
  • Phone: 559-552-3946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number1134437825
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: