Healthcare Provider Details

I. General information

NPI: 1487366597
Provider Name (Legal Business Name): MRS. LISA MARIE FLORES-BERNAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. LISA MARIE FLORES

II. Dates (important events)

Enumeration Date: 12/20/2022
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 E SHAW AVE STE 103
FRESNO CA
93710-8007
US

IV. Provider business mailing address

1551 E SHAW AVE STE 103
FRESNO CA
93710-8007
US

V. Phone/Fax

Practice location:
  • Phone: 559-320-0490
  • Fax:
Mailing address:
  • Phone: 559-320-0490
  • Fax: 559-320-0494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: