Healthcare Provider Details

I. General information

NPI: 1174459564
Provider Name (Legal Business Name): CRYSTAL VIOLETA VASQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N DOUTY ST STE A
HANFORD CA
93230-3783
US

IV. Provider business mailing address

1461 E JEFFERSON CT
REEDLEY CA
93654-4237
US

V. Phone/Fax

Practice location:
  • Phone: 559-423-0744
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: