Provider Demographics
NPI:1962941534
Name:LESTER, WANDA
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:
Last Name:LESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E SIERRA AVE
Mailing Address - Street 2:3106
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-3615
Mailing Address - Country:US
Mailing Address - Phone:559-349-6230
Mailing Address - Fax:
Practice Address - Street 1:100 E SIERRA AVE
Practice Address - Street 2:3106
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-3615
Practice Address - Country:US
Practice Address - Phone:559-349-6230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide