Healthcare Provider Details

I. General information

NPI: 1568358315
Provider Name (Legal Business Name): JIMENA VAZQUEZ CARRANZA BS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 N COURT ST STE B
VISALIA CA
93291-3638
US

IV. Provider business mailing address

1010 N VENTURA AVE
FARMERSVILLE CA
93223-1086
US

V. Phone/Fax

Practice location:
  • Phone: 559-627-1490
  • Fax: 844-368-0871
Mailing address:
  • Phone: 559-967-6677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: