Provider Demographics
NPI:1437228483
Name:STUDENT HEALTH CENTER
Entity Type:Organization
Organization Name:STUDENT HEALTH CENTER
Other - Org Name:NORTH WEST URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STAFF PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIYA
Authorized Official - Middle Name:NESA SHANTHI
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-278-2734
Mailing Address - Street 1:2443 E RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0437
Mailing Address - Country:US
Mailing Address - Phone:559-297-0734
Mailing Address - Fax:559-278-7602
Practice Address - Street 1:5044N BARTON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93740
Practice Address - Country:US
Practice Address - Phone:559-278-2734
Practice Address - Fax:559-278-7602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA050162261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center