Healthcare Provider Details

I. General information

NPI: 1316514979
Provider Name (Legal Business Name): LESLIE GUTIERREZ HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2021
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 S K ST
TULARE CA
93274-5416
US

IV. Provider business mailing address

355 DOVER PKWY STE B
DELANO CA
93215-3441
US

V. Phone/Fax

Practice location:
  • Phone: 559-688-2043
  • Fax:
Mailing address:
  • Phone: 661-725-2788
  • Fax: 661-725-1957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: