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General NPI Number Information
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NPI Number | 1780507236
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Entity Type | Individual
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Provider Name | JOHN DAMERSON
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Gender | Male
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 20 N DEWITT AVE
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City | CLOVIS
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State | CA
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Zip | 93612-1066
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Country | US
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Telephone | 559-477-5546
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 LOMA VISTA PKWY APT 2606
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City | CLOVIS
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State | CA
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Zip | 93619-9841
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Country | US
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Telephone | 559-293-2244
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | D5373655
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License Number State | CA
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