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NPI Code Detail

MEDICARE: KIMBERLY NICOLE OVIEDO AMAGUAYO PA-C

MEDICARE: KIMBERLY NICOLE OVIEDO AMAGUAYO PA-C
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
1363A00000XPhysician Assistant67325CA
2363AM0700XMedical Physician Assistant67325CA

General Provider Information

NPI Number : 1710728688
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY NICOLE OVIEDO AMAGUAYO PA-C
Provider Business Mailing Address
First Line : 2625 E DIVISADERO ST
Second Line :
City : FRESNO
State : CA
Zip : 93721-1431
Country : US
Telephone Number : 559-443-2682
Fax Number : 559-443-2681
Provider Business Practice Location Address
First Line : 2823 FRESNO ST
Second Line :
City : FRESNO
State : CA
Zip : 93721-1324
Country : US
Telephone Number : 559-459-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2024
Last Update Date : 12/03/2025

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Directions to “ KIMBERLY NICOLE OVIEDO AMAGUAYO PA-C” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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