Provider Demographics
NPI:1932910973
Name:VAZQUEZ-GARCIA, FLAVIA ESMERALDA
Entity type:Individual
Prefix:
First Name:FLAVIA
Middle Name:ESMERALDA
Last Name:VAZQUEZ-GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FLAVIA
Other - Middle Name:ESMERALDA
Other - Last Name:VAZQUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4626 E DWIGHT WAY
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93702-4629
Mailing Address - Country:US
Mailing Address - Phone:559-347-7388
Mailing Address - Fax:
Practice Address - Street 1:4626 E DWIGHT WAY
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-4629
Practice Address - Country:US
Practice Address - Phone:559-347-7388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033606363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner