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NPI Code Detail

MEDICARE: SAMANTHA G BUSH

MEDICARE: SAMANTHA G BUSH
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
1373H00000XDay Training/Habilitation SpecialistCA

General Provider Information

NPI Number : 1619831039
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA G BUSH
Provider Business Mailing Address
First Line : 130 W BARSTOW AVE
Second Line :
City : FRESNO
State : CA
Zip : 93704-2156
Country : US
Telephone Number : 559-981-6134
Fax Number :
Provider Business Practice Location Address
First Line : 130 W BARSTOW AVE
Second Line :
City : FRESNO
State : CA
Zip : 93704-2156
Country : US
Telephone Number : 559-939-5999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2025
Last Update Date : 12/11/2025

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Directions to “ SAMANTHA G BUSH ” Practice Location

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