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General NPI Number Information
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NPI Number | 1518700400
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Entity Type | Individual
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Provider Name | STEFANAE SHAELYN FIELDS MS
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Gender | Female
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Dates
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Enumeration Date | 06/17/2024
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 7575 N CEDAR AVE STE 102
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City | FRESNO
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State | CA
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Zip | 93720-2693
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Country | US
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Telephone | 559-321-2322
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Fax |
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Provider Business Mailing Address
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Address Line | 28926 BURROUGH VALLEY RD
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City | TOLLHOUSE
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State | CA
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Zip | 93667-9796
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Country | US
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Telephone | 559-307-7297
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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