| Organization Name: | ST AGNES OCCUPATIONAL HEALTH CENTER |
| NPI Number: | 1003031022 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSE RENTERIA (DIRECTOR) |
| Mailing Address: | 1189 E Herndon Ave Ste 103 Fresno |
| State: | CA US |
| Postal Code: | 937203167 |
| Phone Number: | 5594507777 |
| Fax Number: | 5594507118 |
| NPI Enumeration Date: | 04/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QX0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Occupational Medicine |
| Taxonomy Definition: | |