Healthcare Provider Details

I. General information

NPI: 1013921055
Provider Name (Legal Business Name): KAREN SEGOVIA CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 10/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7045 N MAPLE AVE STE 108
FRESNO CA
93720-8008
US

IV. Provider business mailing address

7471 N FRESNO ST
FRESNO CA
93720-2457
US

V. Phone/Fax

Practice location:
  • Phone: 559-431-0310
  • Fax: 559-431-0301
Mailing address:
  • Phone: 559-436-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4865
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: