MEDICARE: SERENA GOWANI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	373H00000X	Day Training/Habilitation Specialist

General Provider Information

NPI Number	:	1245956291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERENA GOWANI

Provider Business Mailing Address
First Line	:	1925 E DAKOTA AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93726-4821
Country	:	US
Telephone Number	:	559-600-0693
Fax Number	:

Provider Business Practice Location Address
First Line	:	4441 E CESAR CHAVEZ BLVD
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93702-3604
Country	:	US
Telephone Number	:	559-600-9180
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2022
Last Update Date	:	03/09/2026

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