Individual
CAROLINE LOUISE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6311 N FRESNO ST, SUITE 106, FRESNO, CA 93710-5290
(559) 435-4700
(559) 435-9944
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
(559) 443-2682
(559) 443-2681
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA13054
CA
363AM0700X
Medical Physician Assistant
PA13054
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ15011Z
—
CA
Enumeration date
11/11/2006
Last updated
06/11/2014
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