Individual
ELIANA ELIZABETH GERVACIO-ENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6051 N FRESNO ST STE 201, FRESNO, CA 93710
(559) 246-8453
Mailing address
6051 N FRESNO ST STE 201, FRESNO, CA 93710-5280
(559) 246-8453
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
02/16/2024
Last updated
12/10/2025
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