Provider Information
Last Updated : Nov 22 2024 3:48 PM
Michelle M San Jose
City Fresno |
Group HEALTH NET DIRECT FFS MEDI-CAL |
Specialty Qualified Autism Svc Provider |
Last Name San Jose |
First Name Michelle |
Middle Name M |
Address 6760 N West Ave Ste 101 |
State CA |
Zip Code 93711 |
Phone (866)523-4268 |
Hours Mon - Fri 9:00 AM - 5:00 PM |
Gender F |
Title M.S. |
Physician ID 912952 |
Section Number A |
County FRESNO |
Accepting New Patient Yes |
PPG NAME HEALTH NET DIRECT FFS MEDI-CAL |
PPG ID MHDML |
NPI Number 1508107780 |
Access Requirement Limited |
PARKING_IND P |
EXT_BUILD_IND EB |
INT_BUILD_IND IB |
RESTROOM_IND R |
License ID BCB10365 |
Email credentialing@kadiant.com |
Board Certified No |
Self Access Flag Self Reported Data |
Panel Status Available by referral only |