Healthcare Provider Details

I. General information

NPI: 1992374383
Provider Name (Legal Business Name): KABAO YANG THAO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 NW 3RD AVE
VISALIA CA
93291-3628
US

IV. Provider business mailing address

230 NW 3RD AVE
VISALIA CA
93291-3628
US

V. Phone/Fax

Practice location:
  • Phone: 559-839-2670
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95036606
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: