Healthcare Provider Details

I. General information

NPI: 1770998445
Provider Name (Legal Business Name): JOANNE MARIE D GLORIA P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2014
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5117 W NOBLE AVE
VISALIA CA
93277-8354
US

IV. Provider business mailing address

7095 N RECREATION AVE
FRESNO CA
93720-8000
US

V. Phone/Fax

Practice location:
  • Phone: 559-233-3376
  • Fax: 559-233-6647
Mailing address:
  • Phone: 559-233-3376
  • Fax: 559-233-6647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number51705
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: