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General NPI Number Information
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NPI Number | 1023021763
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Entity Type | Individual
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Provider Name | BIANCA TRISTAN FNP
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Gender | Female
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 1551 E SHAW AVE STE 128
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City | FRESNO
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State | CA
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Zip | 93710-8025
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Country | US
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Telephone | 559-320-0490
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Fax | 559-320-0494
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Provider Business Mailing Address
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Address Line | 1551 E SHAW AVE
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City | FRESNO
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State | CA
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Zip | 93710-8024
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Country | US
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Telephone | 559-320-0490
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Fax | 559-320-0494
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN390406
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NPF11252
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License Number State | CA
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