Healthcare Provider Details
I. General information
NPI: 1720945033
Provider Name (Legal Business Name): ELIZA HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/07/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2345 W BEECH AVE UNIT 3994
VISALIA CA
93277-4388
US
IV. Provider business mailing address
167 MADISON AVE RM 205
NEW YORK NY
10016-5403
US
V. Phone/Fax
- Phone: 801-916-5168
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NIKE
AKINJERO
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 559-931-4819