MEDICARE: DR. MARIA JANETTE JERARDI MD, MHS

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	207Q00000X	Family Medicine Physician	A87492	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629022488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA JANETTE JERARDI MD, MHS

Provider Business Mailing Address
First Line	:	4711 W. ASHLAN AVENUE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722
Country	:	US
Telephone Number	:	559-203-6660
Fax Number	:	559-892-0322

Provider Business Practice Location Address
First Line	:	VALLEY HEALTH TEAM CFCHC
Second Line	:	4711 W. ASHLAN AVENUE
City	:	FRESNO
State	:	CA
Zip	:	93722
Country	:	US
Telephone Number	:	559-203-6660
Fax Number	:	559-892-0322

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	09/27/2022

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