Healthcare Provider Details

I. General information

NPI: 1922891928
Provider Name (Legal Business Name): VANESSA ARAISA-HERRERA CSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 WARD AVE STE B10
PATTERSON CA
95363-8529
US

IV. Provider business mailing address

510 KEYSTONE BLVD
PATTERSON CA
95363-8861
US

V. Phone/Fax

Practice location:
  • Phone: 209-648-0560
  • Fax:
Mailing address:
  • Phone: 209-895-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number95095845
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95095845
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: