Healthcare Provider Details

I. General information

NPI: 1548740426
Provider Name (Legal Business Name): KRISTINA MARLENE KOMAR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2018
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E OAK AVE
VISALIA CA
93291-5034
US

IV. Provider business mailing address

PO BOX 2628
VISALIA CA
93279-2628
US

V. Phone/Fax

Practice location:
  • Phone: 559-741-4500
  • Fax: 559-741-4584
Mailing address:
  • Phone: 559-537-0170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95009337
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: