Healthcare Provider Details

I. General information

NPI: 1841042900
Provider Name (Legal Business Name): YANELI MIGUEL MUNOZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2024
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1396 W HERNDON AVE
FRESNO CA
93711-7126
US

IV. Provider business mailing address

1396 W HERNDON AVE
FRESNO CA
93711-7126
US

V. Phone/Fax

Practice location:
  • Phone: 559-216-1997
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number131089
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: