Individual
CITADEL M CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5100 N 6TH ST STE 154, FRESNO, CA 93710-7515
(559) 355-8956
(559) 227-7203
Mailing address
5100 N 6TH ST STE 154, FRESNO, CA 93710-7515
(559) 355-8956
(559) 227-7203
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D5256292
DRIVER'S LICENSE
CA
Enumeration date
10/01/2018
Last updated
10/01/2018
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