Healthcare Provider Details

I. General information

NPI: 1245927193
Provider Name (Legal Business Name): ANAITA KALANJIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 04/20/2023
Certification Date: 04/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 E TULARE AVE
VISALIA CA
93292-1513
US

IV. Provider business mailing address

1901 E TULARE AVE
VISALIA CA
93292-1513
US

V. Phone/Fax

Practice location:
  • Phone: 559-736-6881
  • Fax: 888-355-9911
Mailing address:
  • Phone: 559-736-6881
  • Fax: 888-355-9911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number2023-0000507
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: