MEDICARE: MR. GILBERT DSOUZA

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	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	481568	CA
2	363LF0000X	Family Nurse Practitioner	16458	CA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	16458	CA

General Provider Information

NPI Number	:	1669526752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GILBERT DSOUZA

Provider Business Mailing Address
First Line	:	2615 E CLINTON AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93703-2223
Country	:	US
Telephone Number	:	559-225-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	6051 N FRESNO ST STE 201
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-5280
Country	:	US
Telephone Number	:	559-248-8550
Fax Number	:

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

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	04/29/2025

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Directions to “ MR. GILBERT DSOUZA ” Practice Location

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