Provider Demographics
NPI:1427277417
Name:NAVARRO, PHILLIP
Entity type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:
Last Name:NAVARRO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 M ST
Mailing Address - Street 2:JAIL MEDICAL SERVICES, 2ND FLOOR
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1805
Mailing Address - Country:US
Mailing Address - Phone:559-442-2404
Mailing Address - Fax:559-442-5277
Practice Address - Street 1:1225 M ST
Practice Address - Street 2:JAIL MEDICAL SERVICES, 2ND FLOOR
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1805
Practice Address - Country:US
Practice Address - Phone:559-442-2404
Practice Address - Fax:559-442-5277
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA438974163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse