Healthcare Provider Details

I. General information

NPI: 1255936209
Provider Name (Legal Business Name): MATHEW SEE FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 11/30/2020
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 W PUTNAM AVE
PORTERVILLE CA
93257-3257
US

IV. Provider business mailing address

2520 W STEWART AVE
VISALIA CA
93291-3291
US

V. Phone/Fax

Practice location:
  • Phone: 559-781-3700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95015230
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: