Provider Demographics
NPI:1629022488
Name:JERARDI, MARIA JANETTE (MD, MHS)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:JANETTE
Last Name:JERARDI
Suffix:
Gender:F
Credentials:MD, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4711 W. ASHLAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722
Mailing Address - Country:US
Mailing Address - Phone:559-203-6660
Mailing Address - Fax:559-892-0322
Practice Address - Street 1:VALLEY HEALTH TEAM CFCHC
Practice Address - Street 2:4711 W. ASHLAN AVENUE
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722
Practice Address - Country:US
Practice Address - Phone:559-203-6660
Practice Address - Fax:559-892-0322
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87492207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1992183669Medicaid
CA1962567388Medicaid