Provider Demographics
NPI:1346263225
Name:CSERNA-KINION, JEANETTE (MD)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:CSERNA-KINION
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JEANETTE
Other - Middle Name:
Other - Last Name:CSERNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5479 N FRESNO ST STE 100
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8328
Mailing Address - Country:US
Mailing Address - Phone:559-439-1832
Mailing Address - Fax:559-439-6843
Practice Address - Street 1:5479 N FRESNO ST STE 100
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8328
Practice Address - Country:US
Practice Address - Phone:559-439-1832
Practice Address - Fax:559-439-6843
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39950208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
A28998Medicare UPIN