Healthcare Provider Details

I. General information

NPI: 1891623047
Provider Name (Legal Business Name): HAILEY ANN FERNANDEZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 E HERNDON AVE
FRESNO CA
93720-3309
US

IV. Provider business mailing address

11334 N LA BRISA DR
FRESNO CA
93730-4548
US

V. Phone/Fax

Practice location:
  • Phone: 559-450-3281
  • Fax:
Mailing address:
  • Phone: 559-765-6664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95038445
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95038445
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95296421
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: