Healthcare Provider Details

I. General information

NPI: 1447164835
Provider Name (Legal Business Name): KIASHA MACIEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

823 W LACEY BLVD
HANFORD CA
93230-4328
US

IV. Provider business mailing address

300 W 6TH ST
HANFORD CA
93230-4518
US

V. Phone/Fax

Practice location:
  • Phone: 559-583-5901
  • Fax: 559-469-0112
Mailing address:
  • Phone: 555-583-5902
  • Fax: 559-469-0112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number95238717
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: