Healthcare Provider Details

I. General information

NPI: 1144643404
Provider Name (Legal Business Name): ROBERT S. KELLEHER NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2014
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 E KASHIAN LN STE 280
FRESNO CA
93701-2211
US

IV. Provider business mailing address

505 PARNASSUS AVE # M-917
SAN FRANCISCO CA
94143-2204
US

V. Phone/Fax

Practice location:
  • Phone: 559-320-1090
  • Fax: 559-320-0331
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95000088
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95000088
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: