Provider Demographics
NPI:1356180988
Name:FIERRO, ANDRES SALVADORE
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:SALVADORE
Last Name:FIERRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1796 DONNER AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-4596
Mailing Address - Country:US
Mailing Address - Phone:559-347-1600
Mailing Address - Fax:
Practice Address - Street 1:3045 N BLACKSTONE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703-1015
Practice Address - Country:US
Practice Address - Phone:559-600-6086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker