Healthcare Provider Details

I. General information

NPI: 1700740164
Provider Name (Legal Business Name): ANTHONY ANDREW WILLIAM GALVAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W BARSTOW AVE
FRESNO CA
93704-2156
US

IV. Provider business mailing address

3040 N FRESNO ST
FRESNO CA
93703-1128
US

V. Phone/Fax

Practice location:
  • Phone: 559-981-1630
  • Fax:
Mailing address:
  • Phone: 559-939-5999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: