Provider Demographics
NPI:1669985974
Name:SADAGHIANI, IRIANA JAIME (FNP-C)
Entity type:Individual
Prefix:
First Name:IRIANA
Middle Name:JAIME
Last Name:SADAGHIANI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:IRIANA
Other - Middle Name:S
Other - Last Name:JAIME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2625 E DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1431
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:782 MEDICAL CENTER DR E STE 212
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6889
Practice Address - Country:US
Practice Address - Phone:559-451-3676
Practice Address - Fax:559-451-3680
Is Sole Proprietor?:No
Enumeration Date:2017-11-08
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95007659363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily