Provider Demographics
NPI:1578770905
Name:PAZ B KLOPPENBURG
Entity Type:Organization
Organization Name:PAZ B KLOPPENBURG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED VOCATIONAL NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAZ
Authorized Official - Middle Name:BORJA
Authorized Official - Last Name:KLOPPENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-439-8249
Mailing Address - Street 1:6427 N FRUIT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-1401
Mailing Address - Country:US
Mailing Address - Phone:559-439-8249
Mailing Address - Fax:
Practice Address - Street 1:912 E ROBINSON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-4948
Practice Address - Country:US
Practice Address - Phone:559-229-4060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN168918251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care