Healthcare Provider Details

I. General information

NPI: 1649713157
Provider Name (Legal Business Name): JACQUELINE ARREOLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2016
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2416 W SHAW AVE STE 114
FRESNO CA
93711-3303
US

IV. Provider business mailing address

2416 W SHAW AVE STE 114
FRESNO CA
93711-3303
US

V. Phone/Fax

Practice location:
  • Phone: 559-691-4755
  • Fax: 559-570-0118
Mailing address:
  • Phone: 559-691-4755
  • Fax: 559-570-0118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: