Provider Demographics
NPI:1245950088
Name:VENTRESCA, MARINEH NOUSHIG (FNP)
Entity type:Individual
Prefix:MRS
First Name:MARINEH
Middle Name:NOUSHIG
Last Name:VENTRESCA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 E HOLLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-3815
Mailing Address - Country:US
Mailing Address - Phone:559-349-6252
Mailing Address - Fax:
Practice Address - Street 1:1226 E HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-3815
Practice Address - Country:US
Practice Address - Phone:559-349-6252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016676363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily