Healthcare Provider Details

I. General information

NPI: 1942957113
Provider Name (Legal Business Name): CHIKA AGULANNA PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2022
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E BARSTOW AVE STE 112
FRESNO CA
93710-5023
US

IV. Provider business mailing address

125 E BARSTOW AVE STE 112
FRESNO CA
93710-5023
US

V. Phone/Fax

Practice location:
  • Phone: 951-801-2819
  • Fax:
Mailing address:
  • Phone: 951-801-2819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP95019317
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: