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General NPI Number Information
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NPI Number | 1437228483
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Entity Type | Organization
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Legal Business Name | STUDENT HEALTH CENTER
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5044N BARTON AVE
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City | FRESNO
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State | CA
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Zip | 93740
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Country | US
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Telephone | 559-278-2734
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Fax | 559-278-7602
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Provider Business Mailing Address
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Address Line | 2443 E RICHMOND AVE
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City | FRESNO
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State | CA
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Zip | 93720-0437
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Country | US
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Telephone | 559-297-0734
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Fax | 559-278-7602
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Authorized Official
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Title or Position | STAFF PHYSICIAN
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Name | DR. ARIYA NESA SHANTHI ABRAHAM
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Credential | M.D.
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Telephone | 559-278-2734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A050162
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License Number State | CA
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