Healthcare Provider Details

I. General information

NPI: 1750825212
Provider Name (Legal Business Name): YANIRA LETICIA PACHECO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2016
Last Update Date: 12/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W CYPRESS AVE
REEDLEY CA
93654-2096
US

IV. Provider business mailing address

2150 E JEFFERSON AVE
REEDLEY CA
93654-9343
US

V. Phone/Fax

Practice location:
  • Phone: 559-637-2455
  • Fax:
Mailing address:
  • Phone: 559-393-8521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95005511
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: