Healthcare Provider Details

I. General information

NPI: 1235970294
Provider Name (Legal Business Name): YENI MORENO SMILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W MINERAL KING AVE
VISALIA CA
93291-6237
US

IV. Provider business mailing address

400 W MINERAL KING AVE
VISALIA CA
93291-6237
US

V. Phone/Fax

Practice location:
  • Phone: 559-624-2000
  • Fax:
Mailing address:
  • Phone: 559-624-2213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95029910
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: