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General NPI Number Information
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NPI Number | 1093706350
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Entity Type | Individual
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Provider Name | AMY HELEN WATSON NP, PAC, MSN
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Gender | Female
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 568 E HERNDON AVE SUITE 201
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City | FRESNO
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State | CA
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Zip | 93720-2989
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Country | US
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Telephone | 559-228-6600
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Fax | 559-226-3709
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Provider Business Mailing Address
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Address Line | 560 E HERNDON AVE STE 201
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City | FRESNO
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State | CA
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Zip | 93720-2824
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Country | US
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Telephone | 559-437-7304
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 562830
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 17617
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 15291
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License Number State | CA
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