Provider Demographics
NPI:1609182815
Name:NORTH FRESNO FAMILY HEALTH
Entity Type:Organization
Organization Name:NORTH FRESNO FAMILY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:GUYETTE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:559-436-5265
Mailing Address - Street 1:6081 N 1ST ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5466
Mailing Address - Country:US
Mailing Address - Phone:559-436-5265
Mailing Address - Fax:559-436-4958
Practice Address - Street 1:6081 N 1ST ST
Practice Address - Street 2:SUITE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5466
Practice Address - Country:US
Practice Address - Phone:559-436-5265
Practice Address - Fax:559-436-4958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA386046261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFK834AMedicare Oscar/Certification