Healthcare Provider Details

I. General information

NPI: 1649080219
Provider Name (Legal Business Name): YOLANDA CHAVEZ HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YOLANDA CHAVEZ

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209B E 7TH ST
MADERA CA
93638-3780
US

IV. Provider business mailing address

1058 N BRAWLEY AVE
FRESNO CA
93722-5824
US

V. Phone/Fax

Practice location:
  • Phone: 559-395-0451
  • Fax:
Mailing address:
  • Phone: 559-660-3699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number737597
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: