Healthcare Provider Details

I. General information

NPI: 1396677688
Provider Name (Legal Business Name): HANNA MICHELE HANSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 HWY, 49 NORTH MARIPOSA, CA 95338
MARIPOSA CA
95338
US

IV. Provider business mailing address

5929 E WHITLOCK RD # CA
MARIPOSA CA
95338-9089
US

V. Phone/Fax

Practice location:
  • Phone: 209-966-2000
  • Fax:
Mailing address:
  • Phone: 209-966-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: