Healthcare Provider Details

I. General information

NPI: 1902602873
Provider Name (Legal Business Name): GABRIELA DAVALOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 KINGS COUNTY DR
HANFORD CA
93230-5953
US

IV. Provider business mailing address

460 KINGS COUNTY DR
HANFORD CA
93230-5953
US

V. Phone/Fax

Practice location:
  • Phone: 559-584-1401
  • Fax:
Mailing address:
  • Phone: 559-852-4533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number688496
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: